References
Treating sepsis in the emergency prehospital setting with IV antibiotics
Abstract
Background:
The effectiveness of intravenous (IV) antibiotics for the treatment of sepsis in UK prehospital emergency care is not fully understood. In addition, the views of the key clinical decision-makers in ambulance services have not been documented.
Aims:
This study aimed to provide contemporary, primary data on the opinions of medical directors from across the UK on the use of IV antibiotics to treat sepsis in prehospital emergency care.
Methods:
A qualitative methodology was used. During semi-structured telephone interviews, participants were encouraged to share their personal and professional views on the use of IV antibiotics to treat sepsis in ambulance services. The interviews were recorded and transcribed, and a thematic content analysis using the principles of grounded theory was carried out.
Findings:
Five themes emerged: barriers and enablers; early sepsis recognition; accurate and consistent National Early Warning Score (NEWS) scoring; the need for primary evidence; and standardisation of equipment and protocols. A range of opinions were suggested, with an emphasis on rapid transfers and the need for further evidence.
Conclusion:
There is a drive for early sepsis diagnosis and pre-alerting the receiving hospital. However, there are potential barriers to standardising the approach if paramedics were to collect blood samples and administer IV antibiotics. Additionally, in the absence of UK data on the effectiveness of this treatment, many key decision-makers are reluctant to consider it as a standard approach. Despite this, there is some strong support for using benzylpenicillin for the treatment of suspected sepsis.
Sepsis is a critical complication of an infection, which, if left untreated, can lead to death. In its advanced stage, as a result of an organism's response to an infection, it damages tissues and organs. In further stages, sepsis can lead to septic shock, with the patient subsequently deteriorating into multiple organ failure (Qureshi and Rajah, 2008; UK Sepsis Trust, 2019a).
In the UK, sepsis has a mortality rate of 40%, contributing to the deaths of 44 000 individuals a year. This is higher than deaths from bowel, prostate and breast cancer combined (UK Sepsis Trust, 2019a). This percentage has been shown to be halved if the appropriate care bundle, known as the Sepsis Six, is delivered within 1 hour of severe sepsis being recognised (Steinmo et al, 2016).
Subscribe to get full access to the Journal of Paramedic Practice
Thank you for visiting the Journal of Paramedic Practice and reading our archive of expert clinical content. If you would like to read more from the only journal dedicated to those working in emergency care, you can start your subscription today for just £48.
What's included
-
CPD Focus
-
Develop your career
-
Stay informed