Methodist emergency department staff get a refresher course in identifying and treating a deadly infection.

By Maureen Gilmer, IU Health senior journalist, mgilmer1@iuhealth.org

The patient wasn’t real, but the scenario playing out in IU Health Methodist Hospital’s emergency department last week was all too realistic.

A team of nurses and doctors gathered around a “patient” who was disoriented, feverish and in pain. With little patient history information to go on, they worked together to quickly recognize the signs of sepsis, “a silent killer,” and treat the patient with fluids and antibiotics.

Every year across the United States, more than a quarter-million people die in hospitals as a result of sepsis, defined as a medical emergency caused by the body’s overwhelming response to infection, which can lead to tissue damage, organ failure, amputations and death.

Last year, more than 3,500 Hoosiers died in hospitals from sepsis, according to Indiana Hospital Association data.

As part of Sepsis Awareness Month, teams of nurses and physicians came together in an escape room-type simulation at Methodist to treat a patient who displayed signs of sepsis.

Symptoms include fever, difficulty breathing, low blood pressure, fast heart rate and mental confusion. It can be hard to diagnose because it shares many symptoms with other conditions, but fast treatment often is the difference between life and death.

In this case, the patient was a mannequin brought over from the Sim Center in Fairbanks Hall. As Dane Rogers controlled the mannequin’s voice, Methodist emergency physician Dr. Steven Wipprecht relayed critical information to visiting med student Elizabeth Ogunsanya and nurses taking part in the drill.

In just over 6 minutes, the team had identified and begun treatment for the life-threatening infection. The risk of death from sepsis increases by as much as 8% for every hour that treatment is delayed.

Dr. Wipprecht, who organized the drill and conducted the training outside his regular shift in the emergency department, said his passion is for resident and med student education.

“This is a new cutting-edge way to educate our folks in the department while still getting to do so in a collaborative environment with nursing.”

Stressing the need for active, close-looped communication among doctors and nurses, he said most patient complaints and errors come from missed opportunities for communication. And often, he said, it is nurses who save the day.

Still, three out of 10 people diagnosed with sepsis die. That’s why it is critically important that staff always be alert to the signs of sepsis. Delaying diagnosis and treatment by even 15 minutes can affect mortality.

“Some of our patients are here for weeks, which is why it’s important we do this education on the floors, in the ICUs, because the earlier we get antibiotics in, the mortality rate decreases,” he said.

Because early recognition and timely care are key to improving survival, the Methodist ED “escape room” gave providers, registered nurses and patient care assistants an opportunity to develop a plan and deliver appropriate care in a lifelike circumstance where the clock was ticking.

Emergency medicine intern Becky Yuan said she found the simulation eye-opening.

“It was nice to have the practice in a sim setting before real patients,” she said. “It’s surprising how many patients sepsis affects and the mortality rate. It’s a lot higher than I thought.”

For Methodist RN Jennifer Burchett, the training was valuable, even if just a reminder of the critical work nurses do every day.

“We do really good work here,” she said. “Sepsis isn’t sexy, but it’s not all car accidents and shootings (in the ED). There’s a lot of great work we do that’s not on the highlight reel.”

Dr. Wipprecht ran 10 simulation cases with different teams from the emergency department in one morning. It was the first simulation of its kind for sepsis, but the plan is to go campus-wide with it, he said.

Participants weren’t graded on their performance, but they were encouraged to compete for the best time against other teams. The winning team received Starbucks gift cards.

And all walked out with stickers declaring them “sepsis heroes.”

Photos by Mike Dickbernd, IU Health visual journalist, mdickbernd@iuhealth.org