Pre-hospital lactate measurement: is it feasible?

It is well documented that sepsis is one of the leading causes of death in the UK, associated with high mortality rates and costing the NHS in excess of 2.5 billion pounds every year. Several studies have investigated the effect of recognition tools in the identification of sepsis and septic shock; however, to date, few have explored the contribution of point of care (POC) lactate testing on the early detection of sepsis.

This complex study used a mixed methods design, incorporating both prospective and retrospective components. There were two main objectives: the primary objective was to identify if pre-hospital providers trained in the use of an evidence-based screening tool could recognise severely septic patients; the secondary objective was to distinguish any differences in mortality rates between patients in whom the Sepsis Alert Protocol (SAP) was initiated, or not initiated.

A prospective, 12-month cohort study was completed during 2009 in Denver, Colorado (United States of America). Three emergency departments (EDs) participated in the study, alongside multiple EMS agencies (conveying 57% of the EDs’ admissions).