Childbirth is typically one of the most memorable and emotional moments in the lives of any parent as well as providers who perform full scope obstetrics. Luckily, in 90% of cases infants tolerate the entire process of labor and delivery without issue. However, over 1/1000 infants will develop early-onset sepsis. This devastating disease carries a mortality rate of nearly 11%; 22% in infants less than 37 weeks gestation.
Drs Karen Puopolo, MD, PhD and Gabriel Escobar, MD at Kaiser Permanente developed an interactive early-onset sepsis calculator based on their research on this topic. Their tool estimates the risk of early-onset sepsis in infants born > 34 weeks gestation. The probability of EOS per 1,000 babies is calculated using evidence-based maternal risk factors along with the infant’s clinical presentation. The app then provides the recommended management for these infants. This calculation goes beyond just whether or not an infant is born to a GBS positive mother. The EOS app won’t replace the outstanding Prevent GBS app, but complements it by ensuring vigilance of potentially septic infants regardless of GBS status.
You are on call and have just delivered your continuity OB patient’s newborn male infant. The infant was born at 36 4/7 weeks gestation, GBS negative, with max maternal temperature of 100.3 degrees and was ruptured for 12 hours prior to an uncomplicated spontaneous vaginal delivery. What is this infant’s risk for early-onset sepsis? Anything other than routine care needed? What if the infant is well-appearing or has persistent tachycardia? What if 39 6/7 weeks gestation?
Evidence based medicine
EOS app incorporates an evidence-based algorithm that was derived and subsequently validated to aid in the identification of infants at risk for sepsis and proper management. The app contains numerous supporting references. Using this calculator, providers can ensure maintenance of vigilance and provide early intervention for a condition associated with high mortality. This calculator is not currently available in any other medical calculator apps.
What providers would benefit from this App?
Students, residents, mid-levels, nurses, Neonatologists, Pediatricians, Family Medicine, and Emergency Medicine, and any provider who cares for newborn infants.
Disclaimer: The views expressed are those of the author(s) and do not reflect the official policy of the Department of the Army, the Department of Defense or the U.S. Government.
- Fills a needed void for this useful evidence-based calculator.
- Includes recommended treatment strategies based on results.
- Includes references.
- No summary of the evidence the app is based upon.
- No hyperlinks for references in PubMed.
- Not available for Android.
EOS is a simple but outstanding addition to the app store that takes a proven calculator previously only available online and places it in the hands of providers to use at the point-of-care. This app combined with the GBS app ensures providers are properly evaluating and treating infants at risk for sepsis.
- Overall Score
- User Interface
Easy to use and intuitive interface.
- Multimedia Usage
Contains references supporting the calculator, but no links to PubMed and limited additional information about the evidence upon which the app is based.
App is free!
- Real World Applicability
An app that could save a life by alerting providers to infants’ who may be at risk for early-onset sepsis and ensuring proper management for this potentially lethal diagnosis.
- Device Used For Review
iPhone 6S running iOS 9.3.1
- Available for DownloadiPhoneiPad