Can pre-hospital recognition and intervention improve outcome for patients with severe sepsis?

Pre-hospital provision of care for patients with severe sepsis and septic shock varies significantly throughout the UK. Timely recognition of this complex and highly morbid syndrome is known to be challenging, and significant evidence exists to support the clear association between advancing pre-hospital care and improving patient outcomes. The aim of this literature review is to analyse the opportunities for pre-hospital clinicians to transform the increasing burden of sepsis care. There is evidently a lack of research in this area, reflected in the relative scarcity of relevant research papers. Following a comprehensive literature search, 10 quantitative studies were selected for critical appraisal. Results would suggest that pre-hospital clinicians could effectively contribute to improving outcomes for this patient group. The clinical importance of immediate identification of sepsis is highlighted, recognising the need for sepsis screening aids, standardised pre-hospital evidence-based guidelines and diagnostic tools. Improved communication between pre-hospital clinicians and receiving hospitals was advocated. Further research was proposed to evaluate the effect of pre-hospital therapeutic interventions.

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