Prehospital recognition and treatment of sepsis by paramedics using intravenous antibiotics: A UK-based literature review

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Background: Sepsis mortality rates increase if prompt treatment is not administered and the United Kingdom (UK) ambulance services regularly attend septic patients in the community. The contemporary, gold standard treatment referred to as the Sepsis Six advocates the early administration of broad spectrum, intravenous antibiotics with the view to reduce the mortality and morbidity caused by untreated sepsis. Currently, this approach is not routinely practised at national level in the UK prehospital setting.

Aims: A literature review was conducted to investigate knowledge around Paramedics’ ability to recognise and treat prehospital sepsis with intravenous antibiotics in the UK and the impact of this intervention on patient outcomes.

Methods: The search was conducted using the following databases: EBSCO, CINAHL, MEDLINE, PubMed and Google Scholar. Retrieved studies were screened according to predefined inclusion/exclusion criteria and eligible studies underwent a structured critical appraisal. A thematic synthesis was carried out to summarise and explain the findings.

Findings: Three papers were included in this review and the following themes emerged: (1) Diagnostic accuracy; (2) Administration of prehospital antibiotics; and (3) Impact of prehospital antibiotics on patient outcomes.

Conclusion: There is a significant gap in the body of knowledge in this field, published specifically in the UK. The identified articles utilise different research methodologies and involve small sample sizes making it difficult to make generalised recommendations. It is clear that paramedics have the potential to be highly accurate in the recognition of sepsis in the community and to effectively administer intravenous (IV) antibiotics when following a pre-set protocol. There are no major studies measuring the patient outcomes following the prehospital intervention in the UK and further large scale empirical studies should be conducted, to measure the effectiveness of prehospital intravenous antibiotics administered by paramedics.
Original languageEnglish
Pages (from-to)181-216
JournalJournal of Paramedic Practice
Issue number5
Publication statusPublished - 2 May 2024


  • Sepsis
  • Intravenous Antibiotics
  • Emergency Medical Services
  • Anti-Bacterial Agents

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