Prehospital sepsis care in Ireland: an audit. (2nd July 2020)

• Record Type: Journal Article
• Authors: Mulrooney, Nicola; McCluskey, Patrick; O'Reilly, Martin; Collins, Niamh
• Is Part Of: Journal of paramedic practice. Volume 12:Number 7(2020)
• Page Start: 269
• Page End: 276
• Publication Date: 2020-07-02
• Subjects: Sepsis -- Prehospital -- Call-taking -- Call prioritisation -- Dispatch -- Ambulance -- Paramedic; Emergency medicine -- Periodicals; Emergency medical technicians -- Periodicals; 616.025
• DOI: 10.12968/jpar.2020.12.7.269
• Languages: English
• ISSNs: 1759-1376

Abstract

Abstract : Background: Sepsis is a life-threatening illness that requires early recognition and treatment. In Ireland, mortality, while improving, remains at 17% for adults and in a range of 2–4% in children aged under16 years. Prompt, accurate recognition of severe sepsis in the prehospital period could improve outcomes in patients with severe sepsis. Aim: This study aimed to audit the prehospital care of patients with sepsis against national Irish sepsis clinical practice guidelines and identify areas for improvement. Methods: A retrospective analysis of all Dublin Fire Brigade patient care reports over a 1-week period was carried out and patients with potential sepsis and potential severe sepsis were identified. Care was assessed against the national prehospital clinical practice guidelines. Call-taking and dispatch information were cross-checked. Findings: The incidence of potential sepsis was 3.7%. It is a condition of extremes of age; 8.5% of patients were aged less than 1 year and 58% were aged above 65 years. While 48% of calls were categorised as high priority, about one-third (32%) were put in a low-priority category, and 37% of the latter were potential cases of severe sepsis. The most common chief complaints at the call-taking stage were 'breathing problems' and 'sick person'. Conclusion: Potential sepsis is not infrequent and call-taking information may not capture the potential or severity of sepsis. Education must emphasise the risk in old and young patients. To ensure patients receive timely advanced interventions, call-taking and dispatch systems should ensure that practitioners with the skills to identify and manage sepsis are dispatched to these patients.