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Treating sepsis with intravenous antibiotics in the emergency, prehospital setting: the role of paramedicine, a qualitative study

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

Aims: To provide the contemporary, primary data on the views and opinions of Medical Directors from across 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-structured telephone interviews were carried out, where participants were encouraged to share their personal and professional views on the use of the IV antibiotic intervention, to treat sepsis within the ambulance service. The interviews were recorded, transcribed and a thematic content analysis with the 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 IV antibiotics for sepsis in emergency, prehospital care. These themes were labelled: Barriers and Enablers, Early Sepsis Recognition, Accurate and Consistent NEWS scoring, The Need for Primary Evidence and Standardisation of the Equipment and Protocols. A range of opinions was identified, with the 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-alerting to the appropriate receiving unit. However, there are some potential barriers to standardising the approach, 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 decision makers are reluctant to consider this practice, as a standard approach. At the same time, there are some strong opinions about using the already available Benzylpenicillin, for the treatment of suspected sepsis.
Original languageEnglish
JournalJournal of Paramedic Practice
Publication statusAccepted for publication - 7 Feb 2020

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  • Treating Sepsis with Intravenous Antibiotics

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