Our colleagues from the Asia Pacific Sepsis Alliance (APSA) have launched their new website and unveiled their new logo last Friday - asiapacificsepsisalliance.org.

The APSA was founded in Bangkok in October 2018 and is one of the regional sepsis alliances we are establishing all around the world to work closer with national stakeholders, regional governments, and the WHO regional offices, to implement changes on how sepsis is prioritized, diagnosed, and treated all around the world, as laid out by the WHO Resolution on Sepsis.

The Global Sepsis Alliance is happy to support the Joint Call on Patient Safety and HAI Prevention and Control. A healthcare-associated infection (HAI) is an infection that occurs in a patient during the process of care in a hospital or healthcare facility, which was not present (or incubating) at the time of admission to said facility.

About 20% of sepsis cases can be attributed to HAIs – the remaining 80% are contracted outside of a healthcare facility. Therefore, preventing infections in hospitals is a crucial step to improve patient safety and decrease both sepsis cases and the overuse of antibiotics. Every infection prevented is an antibiotic treatment avoided.

Each November, World Antibiotic Awareness Week increases global awareness of antibiotic resistance and encourages best practices among the general public, healthcare workers, and policy makers.

Sepsis and antibiotics are closely linked – sepsis can occur as the result of antimicrobial resistance and is the driving need for antimicrobial stewardship. Antibiotics are the only really effective treatment for sepsis - for every hour the correct ones aren’t administered, the risk of death increases.

However, this is not the case for all illnesses, so it is crucial to preserve antibiotics for conditions that really need them. For example, nearly 40% of E.coli, the bacteria that causes a huge number of infections, are now resistant to antibiotics, and these organisms account for up to one third of sepsis cases, showing the vital need for responsible use of antimicrobials.

The Global Sepsis Alliance and the World Sepsis Day Movement strongly believe that fighting sepsis with responsible use of antimicrobials and combating antimicrobial resistance can be achieved at the same time.

This is why we are planning on partnering with the WHO to bring you the ‘WSC Spotlight: Sepsis and Antimicrobial Resistance – An Existential Threat’ in early 2020 - stay tuned for more infos soon…

World Prematurity Day on 17 November is one of the most important days in the year to raise awareness of the challenges and burden of preterm birth globally.

The day was initiated by EFCNI and European parent organizations in 2008. In 2010, the US organization March of Dimes, the African organization LittleBigSouls, the Australian National Premmie Foundation, and EFCNI joined across continents to celebrate this special day.

Meanwhile, individuals and organizations from more than 100 countries join forces with activities, events, and commit to action to draw attention to the topic of preterm birth and improve the situation of preterm babies and their families.

This year, the global community celebrates World Prematurity Day under the motto: ‘Born too soon: providing the right care, at the right time, in the right place.’ Besides the color purple - which stands for sensitivity and exceptionality - the socksline has become the symbol for World Prematurity Day. The small pair of purple socks - framed by nine full-size baby socks - symbolizes: 1 in 10 babies is born preterm. Worldwide.

Babies born prematurely often have a weakened immune system, making them especially susceptible to sepsis.

The 3rd Annual Meeting of the European Sepsis Alliance will take place on Monday, March 23rd, 2020 in Brussels, Belgium. Please save the date - the venue, exact time, and program will be announced in early 2020. The 40th ISICEM (International Symposium on Intensive Care & Emergency Medicine) will be held from March 24th to 27th in the Square Brussels Convention Center.

The European Sepsis Alliance was founded under the patronage of the European Commissioner for Health and Food Safety, Vytenis Andriukaitis, at our event “Sepsis - A Call to EU Action” in March 2018 and is part of the GSA strategy to establish 6 regional sepsis alliances spanning the world, implementing the demands of the WHO Resolution on Sepsis, and saving lives. The 2nd Annual Meeting of the ESA was held in March 2019.

Our website now supports your operating systems native dark mode - depending on the settings of your device, this website will be either light or dark, making it more user friendly and easier on the eyes when viewed at night. Please note that you need to use a relatively modern browser for this to work.

How to Enable Dark Mode

Enabling dark mode depends on your device. Here is a quick how-to for the most common operating systems:

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iOS / iPad OS (iPhone / iPad)

1. Make sure you have at least iOS 13.0 installed (you can check in Settings -> General -> Info)

2. Access control center (by swiping down from the top right on Face ID enabled devices or from the bottom up on devices with a home button)

3. Long press on the brightness slider and tap the dark mode icon at the bottom left

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Android (can be different depending on manufacturer)

1. Make sure you have at least Android 10 installed (you can check in Settings -> About Phone -> Software Information)

2. Open the settings app

3. Navigate to Display -> Theme and enable ‘Dark Theme’ (you can also add a tile to the quick settings pull-down menu)

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Mac

1. Make sure you have at least macOS Mojave (10.14) installed (you can check by clicking on the Apple Menu at the top left, and then ‘About this Mac’)

2. Open the settings app and navigate to General

3. Use the buttons at the top to switch between a dark and a light appearance (with macOS Catalina (10.15), you can also set this to automatic, based on sunset at your location)

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Windows

1. Make sure you have at least Windows 10 installed (you can check by clicking on the Start Button -> Settings -> System -> About)

2. Open the settings app and go to Personalization -> Colors

3. Under ‘Choose your default app mode’, choose Dark

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Feedback

We are constantly improving our websites, dark mode is just one of many improvements (although a big one). If you have issues with dark mode, have ideas to improve our websites further, or have other feedback, we’d love to hear from you.

Bonus: Tutorial on How to Implement Dark Mode via Custom CSS on Squarespace

This website (as well as all our other websites) is based on Squarespace - this tutorial will only work on Squarespace. However, the code used might also work for other websites. Naturally, we don’t take any responsibility for this working on your website, but it’s worth a try, isn’t it?

In principle, there are only three steps necessary to implement dark mode.

1. Set up your website to ‘see’ what mode the device of the visitor is in and adapt to it accordingly

2. Define what items become what color when dark mode is enabled

3. Add the code to your Squarespace page (Design -> Custom CSS)

Item one is relatively easy, the code for this is “@media (prefers-color-scheme: dark)”. Item two is a little more tricky, as you first have to find out how the item you want to change is called. You can do this via the ‘inspect’ command of your browser (right-click on the item you want to inspect, and then ‘inspect’). For example, the author name on a blog post is addressed with the item “.Blog-meta-item.Blog-meta-item--author”. As soon as you have found out what the item you want to change is called, you can address it with a simple “color : #HEXCODE”) or “background-color : #HEXCODE”.

Here is the full code we have used:

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@media (prefers-color-scheme: dark) {

body, .Index-page, .Footer-inner, .Footer-blocks, .Footer, .Main-content, .BlogItem-title, .Blog-meta-item, .Blog-meta-item.Blog-meta-item--author, .BlogItem-pagination-link-title, .BlogItem-pagination-link-label {

background-color: #1C1C1E ;

color: #C2C2C2;

}

body, .Main, .tweak-overlay-parallax-enabled.has-parallax-images:not(.tweak-site-width-option-constrained-width) {

background-color: #1C1C1E !important ;

color: #C2C2C2;

}

.Header-search-form-submit svg {

stroke: #C2C2C2;

}

p a , p span {

color: #C2C2C2 !important;

text-decoration-color:#C2C2C2!important;

}

a{ color: #C2C2C2 !important; border-color: #C2C2C2 !important ;}

a, h1, h2, h3, h4, h5 {

color: #C2C2C2 !important ;

}

.medium-button-style-outline .sqs-block-button .sqs-block-button-element--medium:hover {

color: #1C1C1E !important ;

background-color: #C2C2C2 !important}

.large-button-style-outline .sqs-block-button .sqs-block-button-element--large:hover {

color: #1C1C1E !important ;

background-color: #C2C2C2 !important }

.small-button-style-outline .sqs-block-button .sqs-block-button-element--small:hover {

color: #1C1C1E !important ;

background-color: #C2C2C2 !important }

.sqs-use--icon { fill: #C2C2C2

!important ; }

.tweak-social-icons-style-regular .SocialLinks-link-icon { fill: #C2C2C2

!important ; }

.Header-nav--secondary a:hover {

color: #e5007e !important ;

background-color: #C2C2C2 !important }

img {

filter: grayscale(35%);

}

}

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Every November, Movember is celebrated all around the world, raising awareness for men’s health, especially focused on prostate cancer, testicular cancer, and mental health and suicide prevention. Although sepsis does not primarily affect males - it strikes women and men about equally - we encourage you to join the noble cause of Movember this year, by growing a mo to save a bro, move 60km, host an event, or more.

It has long been known that inter- and intra-assessor variability is a common finding in patient assessment by health professionals. This finding holds true both for subjective assessment, for example, estimating a patient’s weight; and objective assessment such as that highlighted here.

In the time-sensitive world of sepsis, few experts recommend that a formal calculation of SOFA score be attempted at the bedside. Instead, reliance is on clinical judgement assisted by ‘screening prompt’ scores aims at the detection of deterioration such as NEWS, MEWS, and qSOFA. Such schools are based on some evidence, and are one of our greatest assets in the battle against harm from deterioration. However, education around the use of these tools must recognize that they are only an adjunct: it is illogical, for example, to suggest that the thresholds for action around heart rate should be identical in an 18-year-old athlete and an 88-year-old with cardiorespiratory disease.

This study now highlights that our ability to reliably reproduce measurement is one of the most important markers of deterioration, respiratory rate, is impaired.

The potential impact of this variability for individual patients, as well as in improvement programs, is huge. Put simply, the variability between health professionals could make the difference between activating a sepsis pathway or not.

A key call to action arising from these findings, and applicable to all healthcare settings including in low- and middle-income countries, is that we get back to the basics and reinforce to health professionals the importance of using a timepiece to accurately record respiratory rate over a full minute.

For healthcare systems with access to technological solutions, this does also bring into question the appropriateness of infrequent intermittent observations. Continual physiological assessment, including assessment of the utility of wearable technology, could help to reduce variability and mitigate against harm. Studies have already shown that such systems have potential to reduce the time to recognition of deterioration.

This study is not transformational. What it does do is to reinforce to us the fact that we are reliant on the eyes and ears of health professionals around the world to activate treatment bundles for sepsis. It reminds us that there is variability even when trained professionals are assessing, and that repeated assessments and opportunities for juniors to request further review are essential steps in mitigating against harm arising from missing cases of sepsis.