Adult sepsis in a pre-hospital environment

Sepsis is a syndrome with a high mortality rate, increasing incidence, and a huge financial impact that must be recognised earlier and treated more effectively both in hospital and pre-hospitally. This article serves to focus on the improvements that need to be made in pre-hospital recognition and management in order to maximise patient outcome, as a high standard of care initiated at an early stage has been demonstrated to decrease morbidity and mortality. There are currently no ratified guidelines for pre-hospital practitioners to follow for the management of sepsis, severe sepsis or septic shock, although the authors recognise that steps are being taken to remedy this. Current guidelines for fluid resuscitation also do not currently support the need for aggressive treatment of sepsis and cryptic shock. Improvements need to focus on education around the sepsis syndrome, recognition of sepsis and early, goal-directed treatment for the benefit of our patients and in order to meet the standards required of paramedics as professionals.

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