Management of severe sepsis and septic shock in the emergency department: a survey of current practice in emergency departments in England.

Aim: To identify the extent to which emergency departments (EDs) in England are involved in the initiation of the pathway to early goal-directed therapy (EGDT) in patients with severe sepsis and septic shock.

Method: A survey of 173 EDs in England was carried out over a 2-month period starting in March 2006.

Results: 117 (67.6%) departments responded. 22 (18.8%) departments satisfied the following criteria: had a strategy to identify these patients, measured lactate, had a written protocol including EGDT and provided training for their staff. A further 10 (8.5%) EDs were working on initiating the pathway to EGDT.

Conclusion: 18.8% of EDs in England are able to initiate the pathway to EGDT in patients with severe sepsis and septic shock.