Publication

Moving sepsis care to the front line: knowledge and views of pre-hospital clinicians

Roebuck, Elizabeth
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Keyword
Emergency Medical Services
 Sepsis
 Ambulatory Care
 Pre-hospital Care
 Paramedic Practice
Journal Title
Journal of Paramedic Practice
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Publication Volume
Publication Issue
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Publication End Page
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Publications - North East Ambulance Service
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URI
http://hdl.handle.net/20.500.12417/435
DOI
10.12968/jpar.2015.7.9.446
Abstract
Abstract published with permission. Background: Previous in-hospital studies have highlighted the opportunity pre-hospital clinicians have to recognise sepsis at an early stage. Left untreated, mortality in septic shock increases rapidly. Sepsis screening tools have been developed to assist recognition; however, current knowledge of sepsis, effectiveness of previous training and attitudes towards implementation of a screening tool is unknown. Methods: A survey was emailed to 529 paramedics and 131 advanced technicians in the North of England to determine their current knowledge of sepsis, views around previous training and the use of a screening tool. Case studies were included to investigate current management of patients with history of infection. Results: 144 clinicians completed the survey, gaining a 21.8% response rate. 54% (95% CI 46%, 62%) of clinicians felt like they had good knowledge, leaving 46% of clinicians feeling a lack of knowledge. 94% (95% CI 89%, 97%) thought emergency departments should treat sepsis immediately or within the first hour. Case studies highlighted variability in the management pathways chosen and 98% (95% CI 94%, 99%) of clinicians required further training. 97% (95% CI 92%, 99%) agreed a screening tool would assist in the identification of septic patients and 98% (95% CI 95%, 99%) would use the tool. Conclusions: Severity level and importance of quick recognition and management are acknowledged among clinicians. Although response rate is a limitation of this study, knowledge levels differentiate greatly among the cohort and nearly all state they require further education. Clinicians agreed a screening tool would help identify septic patients and would use it alongside clinical acumen.
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