Fremont-Rideout Health Group Launches Groundbreaking Programs for the Treatment of Shock.

Aggressive Treatment Proven to Improve Patient Outcomes

YUBA CITY, Calif. -- Research has proven rapid response is crucial in the successful treatment of shock. This week, Fremont-Rideout Health Group (FRHG) launched two groundbreaking programs, 10 Signs of Vitality (10 SOV) and Shock Team and Rapid Response Team (STaRRT) for the quick recognition and treatment of shock, a common condition where there is inadequate blood flow and/or oxygen to the vital organs. FRHG is the first healthcare provider in the United States to offer a comprehensive shock program that includes treatment of hypoxic shock.

Led by Frank Sebat, M.D., a critical care physician at FRHG, the nursing and respiratory therapy staff has been trained to recognize a certain set of "shock criteria." When a combination of two of the 10 SOV are identified as abnormal or if the care nurse is seriously concerned about their patient, a "STaRRT ALERT" is called and the Rapid Response Team responds. Treatment protocols, which have been developed using evidence-based medicine, are instituted as appropriate.

A clinical trial studying the shock program headed by Dr. Sebat, and launched seven years ago at Shasta Regional Medical Center in Redding, California, saw a significant decrease in the mortality rate for all shock, from 40 percent to 11 percent. For the septic shock subgroup, mortality decreased from 50 percent to 10 percent.

By recent reports, even with optimal treatment, mortality due to severe sepsis or septic shock is approximately 40 percent and can exceed 50 percent in the sickest patients. The dramatic results from the Shasta program were published in an article "Effect of a rapid response system for patients in shock on time to treatment and mortality over five years" in the November 2007 issue of Critical Care Medicine with an associated editorial.

"The STaRRT program at FRHG is a change from the conventional shock model and program," said Dr. Sebat. "By including hypoxic shock, we believe we will capture more patients at risk - particularly patients with a deteriorating level of consciousness or respiratory conditions leading to hypoxia as well as patients suffering from the conventional forms of shock."

With the new 10SOV and STaRRT programs, patients benefit because the focus is on early recognition of sometimes very subtle signs and symptoms of shock. The narrow window to recognize and treat a shock victim successfully is referred to as the golden hour.

"If we recognize and can get to these patients early and treat them aggressively with evidence-based best practice, we can continue to improve patient outcomes," said Dr. Sebat.

Traditional definitions of shock include categories such as septic shock due to infections, cardiogenic shock due to heart attack, obstruction of blood flow or other significant cardiovascular events, anaphylactic shock caused by severe allergic reactions and hypovolemic shock due to severe blood and fluid loss. Shock is 100 percent fatal if not treated. Hypoxic shock, a term coined by Dr. Sebat and his team, refers to shock caused by lack of oxygen in the blood, which is typically recognized as respiratory failure from various causes.

We conservatively estimate septic and hypovolemic shock combined affects approximately 500,000 annually in the United States. The combined mortality of septic and hypovolemic shock is estimated at 200,000 people annually in the United States and would therefore be the third leading cause of death. However, the new STaRRT program has the potential to save 60,000 to 100,000 lives per year nationwide.

"This new program is being studied to assess the effect of adding hypoxic shock to the conventional definitions of shock. This form of a Rapid Response System (RRS), which is being launched at additional hospitals, will likely become the standard of care in our medical community and possibly throughout the United States," said Dr. Sebat.

The Fremont-Rideout Health Group includes three acute care hospitals -- Fremont Medical Center in Yuba City, CA, Rideout Memorial Hospital in Marysville, CA and Biggs-Gridley Memorial Hospital in Gridley, CA. Fremont-Rideout also operates The Fountains skilled nursing facility, Courtyard Assisted Living Facility, The Gardens Alzheimer's Facility and Feather River Surgery Center. Other services including Home Care, Hospice, Great Beginnings, and the Occupational Health Clinics. For information on Fremont-Rideout Health Group go to www.frhg.org.