Treating sepsis in the emergency prehospital setting with IV antibiotics

Patryk Jadzinski, Chris Markham

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Background: The effectiveness of the use of intravenous (IV) antibiotics for treatment of sepsis in theUnited Kingdom, in the prehospital emergency care, is not fully understood. Equally, the views of thekey clinical decision makers in ambulance services, associated with this type of treatment, have notbeen documented to this date. 

Aims:To provide the contemporary, primary data on the views and opinions of Medical Directors fromacross the UK, on the use of IV antibiotics for treatment of sepsis in prehospital emergency care. 

Methods:This study used a qualitative methodology, in order to develop new knowledge. Semi-structuredtelephone interviews were carried out, where participants were encouraged to share their personaland professional views on the use of the IV antibiotic intervention, to treat sepsis within theambulance service. The interviews were recorded, transcribed and a thematic content analysis withthe principles of grounded theory was carried out. 

Findings:Analysis of the data, identified five themes related to the views of Medical Directors, on the use of IVantibiotics for sepsis in emergency, prehospital care. These themes were labelled: Barriers andEnablers, Early Sepsis Recognition, Accurate and Consistent NEWS scoring, The Need for PrimaryEvidence and Standardisation of the Equipment and Protocols. A range of opinions was identified, withthe emphasis on rapid transfers and the need for further evidence. 

Conclusion:There are encouraging results, indicating that there is a drive for early sepsis diagnosis and pre-alertingto the appropriate receiving unit. However, there are some potential barriers to standardising theapproach, if it was proposed for paramedics to collect blood samples and administer IV antibiotics.Additionally, in the absence of UK data on the effectiveness of this treatment, many key decisionmakers are reluctant to consider this practice, as a standard approach. At the same time, there aresome strong opinions about using the already available Benzylpenicillin, for the treatment ofsuspected sepsis. 
Original languageEnglish
Pages (from-to)277-287
JournalJournal of Paramedic Practice
Issue number7
Publication statusPublished - 2 Jul 2020


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