References

Daniels R Surviving the first hours in sepsis: getting the basics right (an intensivist's perspective). J Antimicrob Chemother. 2011; 66:ii11-23 https://doi.org/10.1093/jac/dkq515

Daniels R, Nutbeam I, McNamara G, Galvin C The sepsis six and the severe sepsis resuscitation bundle: a prospective observational cohort study. Emerg Med J. 2011; 28:(6)507-12 https://doi.org/10.1136/emj.2010.095067

Department of Health. 2015. www.gov.uk/government/news/new-action-to-reduce-sepsis (accessed 20 August 2015)

Gray A, Ward K, Lees F The epidemiology of adults with severe sepsis and septic shock in Scottish emergency departments. Emerg Med J. 2013; 30:(5)397-401 https://doi.org/10.1136/emermed-2012-201361

Iwashyna TJ, Ely EW, Smith DM, Langa KM Long-term cognitive impairment and functional disability among survivors of severe sepsis. JAMA. 2010; 304:(16)1787-94 https://doi.org/10.1001/jama.2010.1553

Kumar A, Roberts D, Wood KE Duration of hypotension prior to initiation of effective antimicrobial therapy is the critical determinant of survival in human septic shock. Crit Care Med. 2006; 34:(6)1589-96 https://doi.org/10.1097/01.CCM.0000217961.75225.E9

Miller RR, Dong L, Nelson NC Multicenter implementation of a severe sepsis and septic shock treatment bundle. Am J Respir Crit Care Med. 2013; 188:(1)77-82 https://doi.org/10.1164/rccm.201212-2199OC

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Sterling SA, Miller WR, Pryor J, Puskarich MA, Jones AE The impact of timing of antibiotics on outcomes in severe sepsis and septic shock: a systematic review and meta-analysis. Crit Care Med. 2015; 43:(9)1907-15 https://doi.org/10.1097/CCM.0000000000001142

Paramedics have a clear role to play in the management of patients with sepsis

02 September 2015
Opinion
02 September 2015
Volume 7 · Issue 9

Over the past decade, sepsis has risen to political, public and health professional attention as a major cause of avoidable death and morbidity. In September 2014, NHS England issued a Stage 2 Safety Alert on sepsis (NHS England, 2014), reinforced by an announcement of intent from the Secretary of State for Health in January 2015 (Department of Health, 2015).

Sepsis is conservatively estimated to affect over 100 000 adults and children in the UK annually, with 37 000 deaths resulting (Daniels, 2011) and long-term morbidity affecting around 20% of survivors (Iwashyna et al, 2010). Research has shown us how hospital-focused improvement programmes can significantly improve outcomes, with mortality rates reducing by almost one half in several studies (Daniels et al, 2011; Miller et al, 2013). It has been well described that paramedics can positively impact on hospital performance—thereby saving lives—by screening for sepsis and pre-alerting the receiving hospital (Gray et al, 2013), but the profession rightly intends to go a step further by initiating the lifesaving therapies detailed in care bundles such as the UK Sepsis Trust's Sepsis Six.

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