We asked EMS1 readers to identify the primary prehospital treatment for sepsis, a highly exaggerated immune response to an infection. Severe sepsis affects more than one million people in the U.S. Between 26 and 50 percent of those patients with sepsis die and the rate of sepsis is rising [1].
Recognition and treatment by EMS providers can reduce the sepsis mortality rate [2]. Early fluid therapy and hospital notification for antibiotic treatment may contribute to a better survival rate for sepsis patients who are transported by EMS.
The EMS1.com homepage poll question asked:
The primary prehospital treatment for sepsis is IV fluids, high-flow oxygen, vasopressors or oral antibiotics:
Three-quarters (76 percent) of respondents selected IV fluid bolus. Sixteen percent chose high-flow oxygen. Perhaps this reflects a subset of participants who are BLS providers who are unable to administer IV fluids. Though, if sepsis is recognized and an ALS intercept is available, a BLS responder should strongly consider activating ALS. If the patient has signs of hypoxia, administer oxygen.
Vasopressors, like dopamine, were chosen by four percent of respondents. Another four percent of respondents chose oral antibiotics. Drugs are likely part of the patient’s course of treatment, but they are not the primary treatment. Some EMS systems authorize paramedics to administer IV antibiotics during transport.
Prepare for sepsis
Because sepsis is a common, but often unrecognized patient presentation, it is important to learn and review the signs and symptoms of sepsis. Here are 10 of our most popular articles and original videos on the assessment and treatment of sepsis.
- Sepsis 3.0: Implications for paramedics and prehospital care
- 6 useful sepsis assessment and treatment tips
- Sepsis detection and monitoring in EMS
- How capnography can be used to identify sepsis
- Tips for assessing and managing a patient with “general illness”
- Remember 2 Things: Aggressive EMS treatment of sepsis
- Sepsis: 10 things you need to know to save lives
- Quiz: Use of Capnography in the assessment of sepsis patients
- Capnography and Sepsis in the Prehospital Environment
- Consensus definitions for sepsis and septic shock
References
1. National Center for Health Statistics Data Brief No. 62 June 2011. Inpatient care for septicemia or sepsis: a challenge for patients and hospitals
2. Guerra, W. F., Mayfield, T. R., Meyers, M. S., Clouatre, A. E., & Riccio, J. C. (2013). Early detection and treatment of patients with severe sepsis by prehospital personnel. Journal of Emergency Medicine, 44(6), 1116–1125. doi:10.1016/j.jemermed.2012.11.003