Guidelines that go beyond guidance and move to regimented, time-based prescriptions of care must be based on unassailable evidence. Even then, the clinician's assessment of the individual patient should allow a diversion from the guideline directed care.
The current iteration of the Surviving Sepsis Campaign Guidelines (2018) fails on all counts:
- The recommendations are based on low to moderate quality evidence. Even this level of evidence lumps into one group various severities of illness.
- Despite this, the recommendations are made at a Strong level without conditionals
- No consideration is made for the judgment of clinician as to whether the individual patient in front of them will be helped or harmed by the recommendations
- No consideration has been made for the downstream effects these guidelines will have on other non-septic patients being cared for simultaneously.
As such, the under-signed clinicians ask that these guidelines not be used as the foundation of any hospital-specific guidelines/protocols, government interventions,or mandated care. Further, we hope the Surviving Sepsis Campaign retracts these guidelines and integrates a realistic vision of how non-theoretical care is delivered in Emergency Departments, Hospital Wards, and Intensive Care Units and embraces respect for the knowledge and skills of clinicians treating their individual patients at the bedside.
(Please put down the address of your hospital, not your home address and please put your credentials after your last name.)
