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New York & London – The Rory Staunton Foundation and Global Sepsis Alliance today announced that they will unite to fight against sepsis, which claims 8-9 million lives annually. They aim to collaborate to create Global Sepsis awareness & mandates.

On January 13th, as a result of the remarkable success of the efforts of the Rory Staunton Foundation New York Governor Cuomo made New York the first USA State, and among the first governments worldwide, to establish statutory regulations for sepsis management. ‘Rory’s Regulations’ require hospitals to adopt proven practices for the early identification and treatment of sepsis.

12 year-old Rory scratched his elbow playing school basketball on March 29th 2012. He soon became unwell and, having previously been sent home from a leading New York hospital, died four days later from unrecognized sepsis.

The Rory Staunton Foundation’s achievements under the direction of Orlaith and Ciaran Staunton came to the attention of the Global Sepsis Alliance (GSA), under the leadership of Dr Konrad Reinhart and Dr Ron Daniels, as a shining example of strategies to engage governments. The GSA has achieved world successes in engaging professional societies, healthcare providers and policy makers.

Both organizations call governments around the world to examine their response to sepsis. National strategies in New York, Wales and Scotland will be used as examples to drive response.

Sepsis facts

*Sepsis affects over 26 million people worldwide each year.
One third die
*It is the largest killer of children and new-born infants in the world
*Sepsis is increasing at an annual rate of 8-13%

Sepsis is a life-threatening illness arising from the body's response to infection. More common than heart attacks, and more deadly than stroke, sepsis strikes with devastating ferocity in all countries, and is the leading cause of maternal death. Sepsis respects no age, race, gender, or economic status. Sepsis kills far more people than AIDS, and requires a global fight of equal magnitude.


Contacts:
Global Sepsis Alliance
K. Reinhart & R. Daniels

http://www.globalsepsisalliance.org

Rory Staunton Foundation
Orlaith & Ciaran Staunton

http://www.rorystaunton.com

Note from the Global Sepsis Alliance Chairman, Konrad Reinhart:

World Sepsis Day Supporter,

find the World Sepsis Day Report with lessons learned of our meeting with the representatives of the GSA member organisations and the WSD steering committee members. The meeting was very encouraging not only due to the presence of representatives from all continents but also to hear what had been done on WSD 2012 we so far were not yet aware of.

hope you are supportive of our goal to increase the numbers of hospitals which support the World Sepsis Declaration and WSD to 2500 and also the goal to get involvement of governments and health care authorities in quality improvement initiatives and regulations in at least 10 countries in 2013.

On the first World Sepsis Day on September 13th 2012, the German Sepsis Society and the Global Sepsis Alliance organized a charity event in Berlin for a little girl that suffered from sepsis. More than 200 guests donated in total 22,610 Euros. This week, Prof Frank Brunkhorst (German Sepsis Society) and Prof Konrad Reinhart (Global Sepsis Alliance) forwarded the check to the family. The parents are very happy that now they can rebuild the house for more free movement of little Anina.

On January 28th, the heads of World Sepsis Day, K. Reinhart and R. Daniels met with D. Pittet, E. Kelley and B. Allegranzi, the key representatives of the WHO “Clean Care is Safer Care” initiative, in Geneva. They agreed to support each other for the mutual benefit of both campaigns to develop global measures to fight health care-associated infections and thus sepsis. On the 5th May, the global annual hand hygiene campaign “SAVE LIVES: Clean Your Hands” celebrates hand hygiene promotion to improve & sustain hand hygiene and help save lives by reducing health care-associated infection.

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As the Rory Staunton Foundation announced yesterday, the governor of New York, Andrew Cuomo, mandated statewide sepsis protocols to identify and treat sepsis. He “is taking unprecedented measures to prevent and effectively treat sepsis in healthcare facilities across the state and is looking at a wide range of additional measures to better protect patients”. This is a result of relentless efforts and actions of Orlaith & Ciaran Staunton, Founders of the Rory Staunton Foundation, who had lost their son because of sepsis.“ Our mission is to ensure that no other child or adult dies from this vigilant killer. It is our sincere hope that the domestic and international recognition of Governor’s Cuomo’s mandates will act as a catalyst for early recognition and treatment of sepsis. We want to see the New York sepsis protocols adopted in every state in our nation and by the federal government. It is too late for our treasured son Rory, however, it would be his fervent wish to stop sepsis dead in its tracks, saving hundreds of thousands of lives.”

The day after World Sepsis Day, registrar Scott Neck detected sepsis symptoms narrated by a patient after he received a pamphlet about sepsis.

Scott Neck works at Eastside Medical Center as a patient registrar. Registrars are responsible for checking patients into the hospital. Registrars are not clinically trained to care for patients but they care for them in other ways by making sure the check-in process goes smoothly. On September 13, he received a pamphlet about the warning signs of sepsis. He read through it and went about his day. The next day Scott was faced with a situation he didn’t expect; one that would require him to recall the sepsis information on the pamphlet.


His impressions of the day:
„ I am a Patient Access Registrar with the Admissions portion of the hospital. Because our department is not a clinical department, I actually never went through any formal sepsis training. However, the Quality and Infection Control Department had set up a booth with pamphlets that outlined the warning signs and symptoms for sepsis, so I picked one up and read it over lunch! The following day, I brought a patient into my booth to get her registered for a routine chest x-ray. She was shaking in her wheelchair and said she was freezing cold even though she had numerous layers of blankets piled on top of her. I remembered those to be a couple of the physical symptoms of possible sepsis. I notified my manager, who provided me with the number for the Infection Control department. Several nurses were in my booth assessing the patient within the minute, and she was then quickly escorted to the Emergency Department. It feels awesome. I feel fortunate to have been in a position to help her get the care she needed. This event definitely opened my eyes to the immense amount of influence each of us has on the patients we care for. Clinical and non-clinical alike, we all have the ability to help create an environment that serves the patient the best way possible.“

This event organized, jointly by the ED at SCH and the National School for Emergency Care was attended by around 100 participants and it was held in the presence of concerned institutions and decision makers, like
¬ Dr Nada Ghosn from the Ministry of Public Health (MoPH)
¬ Dr Hassan Al Bushra: World Health Organization (WHO) representative in Lebanon.
¬ Dr Nisrine Bazarbachi: President of the Lebanese Society of Emergency Medicine (LSEM)
¬ Dr Rima Moughania: President of the Lebanese Society of Infectious diseases and clinical microbiology (LSIDCM),
¬ Dr Georges Abi Saad: former President of the Lebanese Critical Care Society (LCCS),
¬ Dr Nadine Yared: Head of the internal medicine Dept - Faculty of Medicine at the Lebanese University (FM-LU).
¬ Prof. Peter Cameron (IFEM President)
¬ Dr Nagi Souaiby (NSEC Director)

During a round table directed by Dr Nadine Yared, with all the aforementioned stakeholders, the audience was able to spark some points of view and the group agreed on the following recommendations:
1. The MoPH (Ministry of Public Health) introduces a new criterion for the accreditation of hospitals in Lebanon, namely those hospitals should appoint trained/accredited emergency room physicians for the management of emergency departments.
2. The MoPH to work with the concerned scientific societies in order to set national guidelines for the management of sepsis as an emergency condition.
3. The MoPH to work along with the concerned scientific societies and with nursing schools, in order to arrange for the adequate training of the emergency room personnel, to recognize severe sepsis as an emergency and to act accordingly.
4. The LSEM to initiate a workforce/ subcommittee to collaborate with other concerned societies like the LSIDCM and LCCS as well as with the MoPH to help writing down National Guidelines for the management of Sepsis as an emergency condition and to lobby for the introduction of a regulation stipulating that emergency room physicians be responsible for emergency departments in the country.
5. The WHO to provide help and consultancy as deemed appropriate for the LSEM to accomplish the above recommendations. It is understood that the role of the WHO is supportive.

These outstanding results of the conference are milestones toward the goals of the World Sepsis Declaration in Lebanon.
The conference was organized by Drs Nadine Yared, Charles Nahas, Pierre Abi Hanna, Antoine Haddad, Dany Raad and Nagi Souaiby.

The Cabinet Secretary for Health & Wellbeing at the Scottish Government, Nicola Sturgeon, has agreed to sign the declaration on behalf of NHS Scotland. This demonstrates the high level support for the World Sepsis Declaration on a national level. Scotland is the first country to have demonstrated this central organization commitment to the Declaration. The Minister will sign the declaration itself at a reception in Edinburgh.

The Alliance to Save Our Antibiotics, a coalition founded by Compassion in World Farming, the Soil Association and Sustain, supports World Sepsis Day and the World Sepsis Declaration. The main focus of the Alliance is to significantly reduce the overuse of antibiotics in livestock farming in the European Union, particularly targeting the reliance of intensive farming on the prophylactic use of antibiotics as a mask for poor animal welfare. The Alliance focuses on the use in livestock of antibiotics that are critically important in human medicine. The danger of overusing antibiotics, particularly in low doses or incomplete courses, is a significant problem and highly concerning with regards to our ongoing ability to treat sepsis. Antibiotic resistance can literally put lives at risk. Through its current campaign to halt the over-use of antibiotics in factory farms, Compassion in World Farming along with Sustain and the Soil Association have collaborated in a unique partnership with the Global Sepsis Alliance (GSA) and as an official supporter of World Sepsis Day to combat the concerns of antibiotic resistance.

AAP News, the official organ of the American Academy of Pediatrics, has issued a call for action to its members in their August issue, asking to join WSD and raise awareness for early recognition and treatment of sepsis.

„Stop sepsis—save lives: A call to join the global coalition for the World Sepsis Day“ has just appeared as free-access article in the Journal of Critical Care (2012) volume 27, pages 410–413. The authors and members of the Global sepsis Alliance (GSA) Reinhart, Kissoon, Daniels and Jimenez describe the World Sepsis Day movement, the aims and goals, and how to participate. A foreword by the editor, Philip D. Lumb, notes that ”Designed to improve public and professional understanding and awareness of the prevalence and lethality of sepsis, the GSA intends to catalyze a worldwise (spelling intended) response to the disease and its prevention wherever possible and early intervention and treatment when necessary.” The Journal of Critical Care is the official publication of the World Federation of Societies of Intensive and Critical Care Medicine (WFSICCM), and is a leading international, peer-reviewed journal providing original research, review articles, tutorials, and invited articles for physicians and allied health professionals involved in treating the critically ill.

One of the largest hospital groups within Central Europe, the Wiener Krankenanstaltenverbund, has announced their support of WSD and the targets of the World Sepsis Declaration. The Vienna Hospital Association includes all hospitals and geriatric centres of the City of Vienna with a total of 32.000 care-givers who provide round-the-clock care. The group presently is responsible for 12 hospitals, including the General Hospital-Medical University Campus, eleven Geriatric Centres, three Residential Nursing Homes and eleven training facilities for general healthcare and nursing care. The Vienna Hospital Association is Austria’s biggest educating institution for healthcare professions. Altogether, there are 2.100 apprenticeship positions available for prospective nurses and for medical-technical training. The Wiener Krankenanstaltenverbund will ask their members to participate in the activities of the WSD. Their support signals the increasing importance of preventing and recognizing sepsis outside the hospital setting and educating care-givers about the early warning signs.

The Federation of Austrian Societies of Intensive Care Medicine has joined the movement and signalled support of the World Sepsis Day. With this step, the president of FASIM, Univ.-Prof. Dr. Andreas Valentin, joins forces with other medical societies worldwide to fight sepsis. The FASIM is the umbrella organisation of all intensive care societies and working groups in Austria.

The Austrian Society for Anesthesiology, Resuscitation and Intensive Care ÖGARI, http://www.oegari.at and the Austrian Society for Medical and General Intensive Care and Emergency Medicine, ÖGIAIN http://www.intensivmedizin.at , both under the roof of FASIM Austria which recently joined WSD, have asked their members to become individual supporters of WSD and the World Sepsis Declaration.

With the support of the World Sepsis Day campaign by Daniel Bahr, Minister of Health, another German ministry has joined the global initiative. Bahr says: “Appropriate prevention strategies are just as important as the early detection and treatment of the disease. The World Sepsis Day informs and, in doing so, makes a valuable contribution to the fight against sepsis.” In Germany, sepsis is a major burden on the health care system, using up a considerable portion of the intensive care budget for acute care.

Prof. Dr. Annette Schavan, federal minister, has declared her support for World Sepsis Day. Minister Schavan says she appreciates this initiative with regards to the enormous challenge that sepsis poses to the health care system with every day. Schavan's Ministry of Education and Research has previously funded national sepsis research activities, such as the competence network for Sepsis SepNet or the Center for Sepsis Control and Care in Jena.

Rory Staunton, a previously healthy young boy, was sent home from the emergency department when early signs of sepsis were not recognized.

During gym class on Wednesday, March 28, he dived for a ball and opened a cut on his arm. Later that night, he developed fever, pain in his leg and started vomiting. Next morning, the family took him to see a paediatrician, who noticed skin mottling, a sign of deranged circulation. Rory’s temperature was 102 and his pulse was 140; he was taking 36 breaths a minute. He was sent to an emergency department, where blood tests were done. He received treatment for dehydration (intravenous fluids), given fever medication and pain killers and was sent home two hours later. At home he deteriorated fast, developed diarrhea and vomiting. His mother recalls that his nose turned blue and that he was screaming at a slight touch. When they took Rory back to the emergency department, he was already well into his fight against septic shock, a fight he ultimately lost. He was admitted to the ICU and put on a ventilator. On April 1, three nights after he was sent home from the emergency room, he succumbed to septic shock. The ICU team had been unable to resuscitate him a third time.

Details of the boy’s treatment and death were reported in The New York Times (Published: July 11, 2012 ,
http://www.nytimes.com/2012/07/12/nyregion/in-rory-stauntons-fight-for-his-life-signs-that-went-unheeded.html?pagewanted=1&_r=4&emc=eta1 ) and have triggered vigorous discussions . NYU Langone Medical Center announced that a new checklist was developed to ensure that a doctor and nurse have conducted “a final review of all critical lab results and patient vital signs” before a patient leaves (NY Times, Jluy 18th, 2012, http://www.nytimes.com/2012/07/19/nyregion/after-rory-stauntons-death-hospital-alters-discharge-procedures.html?_r=1&hp ).

As Jim Dwyer wrote in the NY Times, the challenge for physicians is to recognize an invasive infection, before the cascading damage of sepsis has picked up too much speed. In Rory’s case, bacteria had gotten into his blood, probably through the cut on his arm. He was sliding into a septic crisis, an avalanche of immune responses to infection from which he would not escape. On April 1, three nights after he was sent home from the emergency room, he died in the intensive care unit.

Signs of invasive infection are high or low temperature, rapid breathing, rapid pulse rate, pain, confusion and lethargy. News

On behalf of the European Society of Anaesthesiology (ESA) I am pleased to announce that the ESA has joined the international coalition for the World Sepsis Day. Worldwide the understanding and treatment of sepsis is one of the most challenging medical tasks. The ESA as the most prominent European stakeholder of Anaesthesiology and perioperative care, which includes intensive care, wholeheartedly supports the aims of the World Sepsis Declaration. This declaration is totally in line with the Helsinki Declaration for Patient Safety which was initiated by the ESA.
Prof. Dr. Eberhard Kochs
ESA President

Nature Medicine, a prestigious biomedical research journal for scientists and physicians, has put a spotlight on sepsis in the latest issue. The journal takes an in-depth analysis of the current state of sepsis management and care, pointing out that critical-care specialists currently have no drug therapies they can turn to specifically for the treatment of severe sepsis, a condition that afflicts around 18 million people worldwide each year. Articles in this issue's focus highlight how sepsis researchers are working to overcome those challenges, taking aim at every step in drug development and medical practice.
Nature Medicine, July 2012, Volume 18, No 7, at:

Another German Scientific Society, the German Society for Internal Medicine (DGIM) has joined the World Sepsis Day movement to support the World Sepsis Day and the targets set out in the World Sepsis Declaration. The DGIM is one of the largest medical-scientific societies in Germany with approximately 22,000 members. It was founded in 1882 for German physicians and scientists active in the field of internal medicine.

The Spanish Society of Intensive Care has just announced their support of the the World Sepsis Day. They are currently setting up several activities such as a press conference with the leading Spanish intensivsts to inform the public about the impact of Sepsis and what intensivists can do to improve the situation.

More than 80 kilometers - that is the distance of the 3rd Saale-Horizontale course around the city of Jena which takes place on Saturday, July 7th. Two teams of physicians, scientists and students from the Jena University Hospital and the Jena-based Center for Sepsis Control and Care (CSCC) will participate in this sportive event to raise awareness for sepsis and collect money. Donations will go to the German Sepsis Aid, the first self-help organisation for sepsis survivors and relatives of sepsis patients. Sepsis research and therapeutic strategies to improve survival are key activities at the university hospital.

The German Medical Association (Bundesärztekammer), under the presidency of Dr. med. Frank Ulrich Montgomery, joined the World Sepsis Day movement and supports the World Sepsis Declaration. The German Medical Association is the central organization in the system of medical self-administration in Germany. As the joint association of the State Chambers of Physicians (Landesärztekammer), it represents the interests of 450.000 physicians in matters relating to professional policy, and plays an active role in opinion-forming processes with regard to health and social policy and in legislative procedures.

The Polish Society of Anaesthesiology and Intensive Therapy (PTAiIT) endorses the targets of the World Sepsis Declaration and supports the World Sepsis Day. According to President Professor Maria Wujtewicz this global initiative is very important to movement and will help to establish a continuous effort in the fight against sepsis worldwide that is urgently required. “Any kind of support may lead to improvement of outcome, but we all know that there is still a lot of work to be done”, so Prof. Wujtewicz, “we are proud to be part of this worldwide movement”.

Online first: the New England Journal of Medicine (NEJM) has just released the long-awaited results from the multi-center 6S study “Hydroxyethyl Starch 130/0.4 versus Ringer’s Acetate in Severe Sepsis” conducted by the Scandinavian Critical Care Trials Group. Hydroxyethl starch is a plasma expander used intravenously to treat cardio-circulatory volume deficits. The study found that patients with severe sepsis assigned to fluid resuscitation with HES 130/0.4 had an increased risk of death at day 90 and were more likely to require renal-replacement therapy, as compared with those receiving Ringer's acetate.

The SCCTG is a part of the Scandinavian Society of Anaesthesia and Intensive Care Medicine (SSAI) and conducts multi-center studies in intensive care medicine. Current chairman Anders Perner, associate professor and intensive care specialist from Rigshospitalet, Copenhagen, is also lead author of the so-called 6S study “Hydroxyethyl Starch 130/0.4 versus Ringer’s Acetate in Severe Sepsis” which is now available online on the New England Journal of Medicine (NEJM) website (DOI: 10.1056/NEJMoa1204242).

CCCTG was created in 1989 to improve the care and outcomes of critically ill patients through investigator-initiated research and has since initiated and participated in major research activities in the field. The CCTG has more than 300 members with over 40 active research programs, resulting in over 200 publications, many in high-ranking journals such as the New England Journal of Medicine (NEJM).

The Italian Centre for Clinical Risk Management and Patient Safety of Tuscany Region has also joined the WSD movement. In Italy, the regional Centre for Clinical Risk Management and patient safety (CRM) is the first structure whose mission is to organize a clinical risk management system at regional level.

CRM centre is a clinical governance body, located at the general direction of Tuscany regional health service. CRM centre has the purpose to promote and coordinate initiatives for patient safety throughout the regional healthcare system, which accounts for 3.5 millions citizens. Tuscany’s public health service is subdivided in 3 wide area consortiums and 16 local healthcare agencies, with 50.000 employees distributed in 34 acute care hospitals and hundreds of local wards. There are around 15.000 beds and 650.000 in-patients each year.

The George Institute for Global Health signed the pledge of support for the World Sepsis Declaration. The George Institute is an organisation aiming to improve the health of millions of people worldwide.

The Institute focuses on disadvantaged populations in both higher and lower income countries, who suffer a disproportionate share of the disease burden and are often poorly served by existing health systems. The George Institute aims to find practical ways to improve the health status of disadvantaged populations. In addition, the George Institute aims to improve the prevention and treatment of chronic diseases such as heart disease, kidney disease, diabetes and stroke, are now leading causes of death and disability in both lower and higher income countries in both community and hospital settings. The institute also strives to ensure the sustainability of healthcare services and explores innovative ways to deliver essential healthcare at lower cost while maintaining or improving effectiveness and safety. The institute also explores new approaches to managing injury, frailty and disability and to find new ways to prevent injury and manage frailty in an effort to avoid disability.
Over the last decade, the George Institute has delivered high-impact evidence from a large program of research and innovation that has influenced health policy and healthcare practice worldwide. From modest beginnings, the founders have built a team of more than 300 staff across centres in Australia, India, China and the United Kingdom. The Institute’s projects now span more than 40 countries worldwide.

The Brazilian Association of Intensive Care (AMIB), one of the world’s largest societies of intensive care medicine, joined the Global Sepsis Alliance to support the World Sepsis Day coalition and the World Sepsis Declaration. On behalf of the AMIB directorate, Dr. Ederlon Rao, President, and Prof Ricardo Lima, General Secretary, announced to participate in the actions necessary to improve the prevention and management of sepsis.

The British Columbia Sepsis Network was recently launched, which represents 57 hospitals in this Canadian province. The Network currently includes 90 sepsis champions committed to leading improvements at their site, and will continue to grow and expand to include more clinicians, working towards the goal of improving sepsis care and reducing sepsis mortality. The British Columbia Patient Safety & Quality Council, together with the BC Ministry of Health and the province’s Health Authorities, are supporting this large scale sepsis improvement initiative. Activities will include:

· measuring and reporting quality improvement metrics for sepsis process and outcomes,
· working together to spread sepsis awareness,
· mobilizing other stakeholders,
· educating and engaging with other clinicians in the hospitals, and
· implementing sepsis best practice guidelines.

The BC Sepsis Network is dedicated to support the World Sepsis Declaration and to coordinate local activities for World Sepsis Day on September 13th.

The Helios Hospital Group Germany with its 51 acute care hospitals and 24 rehabilitation facilities decided to support the World Sepsis Day and the World Sepsis Declaration.