Table 3 Prehospital studies of sepsis
From: Suspicion and treatment of severe sepsis. An overview of the prehospital chain of care
Ref | Year | Aim | n | Results |
|---|---|---|---|---|
A. Prehospital treatment | ||||
(1) Meningococcal sepsis | ||||
23 | 1998 | To assess the effect of antibiotics given by GP | 32 | Higher mortality among patients who received antibiotics |
24 | 2002 | To assess the effect of antibiotics given by GP | 534 | The effect of prehospital antibiotics appeared to be dependent on hospital care |
25 | 2006 | To explore mortality and morbidity after parenteral penicillin in children | 158 | Children who were given antibiotics had a more severe disease on admission to hospital |
26 | 2005 | Audit to determine the clinical appropriateness of administrations of benzyl penicillin by paramedics | 69 | Paramedic compliance with guidelines was low (78% failures) |
(2) Fluids | ||||
36 | 2010 | To determine the delivery of out-of -hospital fluids in severe sepsis | 52 | Forty-eight per cent received intravenous fluids |
B. Impact of EMS on care of sepsis patients | ||||
32 | 2010 | To evaluate early recognition and treatment in relation to EMS care | 311 | Patients who used the EMS had more organ failure but a shorter time to antibiotics and EGDT |
33 | 2010 | To characterise patients with sepsis in relation to the use of the EMS | 4,613 | EMS patients were more likely to present with severe sepsis |
34 | 2010 | To describe out-of-hospital characteristics and EMS care among patients with severe sepsis who used the EMS | 216 | Out-of-hospital variables were associated with organ dysfunction at the ED |
42 | 2011 | To assess the impact of the EMS on time to antibiotics, intravenous fluids and mortality in severe sepsis | 963 | Out-of-hospital care was associated with improved in-hospital processes but not mortality |
C. Prediction of outcome | ||||
39 | 2009 | To consider how prehospital staff can improve the outcome in severe sepsis | The article suggests that antibiotics should be given in the prehospital setting and that lactate should be measured | |
35 | 2007 | To assess the predictive effect of physiological elements commonly reported in the out-of-hospital setting on the outcome in severe sepsis | 63 | The out-of-hospital shock index and respiratory rate are highly predictive of ICU admission |
D. Knowledge and attitudes regarding sepsis among EMS staff | ||||
38 | 2010 | To assess the knowledge and attitudes in the diagnosis and management of sepsis in the USA | 226 | Poor understanding of the principles of diagnosis and management of sepsis was observed |