In this study of critically ill adults in ED, the physicians gut impression within 15 minutes performed better than any other existing tool in identifying sepsis So why do we feel forced to use screening tools which we know cause their own problems? annemergmed.com/article/S0196-…
Maybe time to go back to the drawing board and reassess whether sepsis is something we need to be "screening" for at all? bmj.com/content/381/bm…
@apsmunro Interesting. If I may cautiously attempt an answer to your question: For the less gifted ED physicians?
@apsmunro because we don’t have a similar strong proof that it works for children of different age groups as well? probably yes but we need a similar study?
@apsmunro To help and standardise. But nothing is as good as good training and good experience
@apsmunro The physicians were attendings. The same outcome may not be true for trainees. I agree about screening tools. In vascular surgery I often think the 'end-of-the-bed' assessment is just as good or better than CPET/Echo etc in assessing fitness for AAA surgery.
@apsmunro Hard to assess in primary care, but I think results would be similar. Somuch of what we do is related to gut instinct, backed up by obs, but gut often wins over. That's why experience is so important, and years of training.
@apsmunro Sepsis decision tools were never designed to over rule clinician acumen for identifying sepsis. A good clinician and decision tool work best.