I work as a rural generalist in remote areas of Cape York....

I work as a rural generalist in remote areas of Cape York. Mostly emergency based but also GP clinics. Resources very limited.

My patient demographic is mostly indigenous and true "bushies" so you can appreciate that presentations of most medical concerns are late or well into the disease process.

I agree with Starter88 in that sepsis is mostly a clinical diagnosis. Sepsis has well defined treatment pathways/protocols that are commenced even at the slightest concern of sepsis.

Up heree in the middle of nowhere we essentially commence antibiotics immediately and wait for tests. It is very rare that it is subtle. Usually have a multitude of signs and symptoms that make the "endofbed-ogram" all you need to commence treatment.

As for delayed diagnoses. In my experience this has mostly been a result of receiving the patient late in the process (I.e. they didn't turn up until they were about to die)

Now I would love a test that tells me "yes/no" with regards to sepsis. But unlike the troponin, I am not aware of anything that is very specific to sepsis.