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Fast track Alert System Timer (FAST) reduce Time to antibiotic for septic
patients in the Emergency Department

นายแพทย์ศิรสิทธิ์ สถิรเจริญกุล

โรงพยาบาลพระนั่งเกล้า จังหวัดนนทบุรี เขตสุขภาพที่ 4
ประเภท นวัตกรรมและสิ่งประดิษฐ์

ความสำคัญของปัญหาวิจัย
Sepsis is a clinical syndrome of life - threatening organ dysfunction caused by a
dysregulated host response to infection1. Due to its high mortality rate, sepsis has drawn
increased attention in diagnosis and management over the past 30 years. Despite this increasing
attention, sepsis continues to have a high mortality rate2, averaging 39% worldwide. Early

detection of septic patients and aggressive treatment can improve patient outcomes3. Early
antibiotic use, in particular, seems to reduce the mortality rate from sepsis and the progression
of septic shock4.

Many literatures assess the utility of automated alerting systems in sepsis. However,
most of these studies assessed the alerting system's diagnostic accuracy in predicting
sepsis8,9,10, and just a few assessed its usefulness in clinically significant outcomes, such as
mortality

วัตถุประสงค์การศึกษา

In this study, we compared the previous care process with no alert system
(Pre-implementation period) for suspected septic patients in the ED and the new care process
(Post-implementation period), which includes the implementation of the Fast track Alert
System (FAST), which countdowns time from patient arrival to the time that patient gets an

antibiotic.

วิธีการศึกษา
This study is a prospective cohort study, collecting data between April 2023 and
September 2023 in the ED of Pranangklao Hospital, a tertiary care hospital in Nonthaburi,

Thailand, following approval by the Ethics Committee of Pranangklao Hospital (PE6650).
The Pre-implementation period was performed for three months between April and June 2023,
and the Post-implementation period was also conducted for three months between July and

September 2023.
The Fast track Alert System Timer (FAST) is the timer that countdowns the time from
when the patient enters the ED to when the patient receives an antibiotic. The countdown
starts when the eligible patient registers to the ED and has the Search out severity score
or SOS score, calculated from initial vital signs, more than 3, which is shown to have a high

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mortality rate in septic patients . FAST is displayed on a 55-inch display in the Resuscitation
area in the Emergency Department directly in front of the nurse counter. The system