Paramedic Recognition of Sepsis in the Prehospital Setting: A Prospective Observational Study
Background. Patients with sepsis benefit from early diagnosis and treatment. Accurate paramedic recognition of sepsis is important to initiate care promptly for patients who arrive by Emergency Medical Services. Methods. Prospective observational study of adult patients (age ≥ 16 years) transported...
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| Format: | Article |
| Language: | English |
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Wiley
2016-01-01
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| Series: | Emergency Medicine International |
| Online Access: | http://dx.doi.org/10.1155/2016/6717261 |
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| author | Robert S. Green Andrew H. Travers Edward Cain Samuel G. Campbell Jan L. Jensen David A. Petrie Mete Erdogan Gredi Patrick Ward Patrick |
| author_facet | Robert S. Green Andrew H. Travers Edward Cain Samuel G. Campbell Jan L. Jensen David A. Petrie Mete Erdogan Gredi Patrick Ward Patrick |
| author_sort | Robert S. Green |
| collection | DOAJ |
| description | Background. Patients with sepsis benefit from early diagnosis and treatment. Accurate paramedic recognition of sepsis is important to initiate care promptly for patients who arrive by Emergency Medical Services. Methods. Prospective observational study of adult patients (age ≥ 16 years) transported by paramedics to the emergency department (ED) of a Canadian tertiary hospital. Paramedic identification of sepsis was assessed using a novel prehospital sepsis screening tool developed by the study team and compared to blind, independent documentation of ED diagnoses by attending emergency physicians (EPs). Specificity, sensitivity, accuracy, positive and negative predictive value, and likelihood ratios were calculated with 95% confidence intervals. Results. Overall, 629 patients were included in the analysis. Sepsis was identified by paramedics in 170 (27.0%) patients and by EPs in 71 (11.3%) patients. Sensitivity of paramedic sepsis identification compared to EP diagnosis was 73.2% (95% CI 61.4–83.0), while specificity was 78.8% (95% CI 75.2–82.2). The accuracy of paramedic identification of sepsis was 78.2% (492/629, 52 true positive, 440 true negative). Positive and negative predictive values were 30.6% (95% CI 23.8–38.1) and 95.9% (95% CI 93.6–97.5), respectively. Conclusion. Using a novel prehospital sepsis screening tool, paramedic recognition of sepsis had greater specificity than sensitivity with reasonable accuracy. |
| format | Article |
| id | doaj-art-89f95e5084044eef8f585f3a5f322f13 |
| institution | Kabale University |
| issn | 2090-2840 2090-2859 |
| language | English |
| publishDate | 2016-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Emergency Medicine International |
| spelling | doaj-art-89f95e5084044eef8f585f3a5f322f132025-02-03T05:54:19ZengWileyEmergency Medicine International2090-28402090-28592016-01-01201610.1155/2016/67172616717261Paramedic Recognition of Sepsis in the Prehospital Setting: A Prospective Observational StudyRobert S. Green0Andrew H. Travers1Edward Cain2Samuel G. Campbell3Jan L. Jensen4David A. Petrie5Mete Erdogan6Gredi Patrick7Ward Patrick8Department of Critical Care, Dalhousie University, Suite 377, Bethune Building, 1276 South Park Street, Halifax, NS, B3H 2Y9, CanadaDepartment of Emergency Medicine, Dalhousie University, Division of EMS, 1796 Summer Street, Halifax Infirmary, Suite 355, Halifax, NS, B3H 3A7, CanadaDepartment of Emergency Medicine, Dalhousie University, Division of EMS, 1796 Summer Street, Halifax Infirmary, Suite 355, Halifax, NS, B3H 3A7, CanadaDepartment of Emergency Medicine, Dalhousie University, Division of EMS, 1796 Summer Street, Halifax Infirmary, Suite 355, Halifax, NS, B3H 3A7, CanadaDepartment of Emergency Medicine, Dalhousie University, Division of EMS, 1796 Summer Street, Halifax Infirmary, Suite 355, Halifax, NS, B3H 3A7, CanadaDepartment of Emergency Medicine, Dalhousie University, Division of EMS, 1796 Summer Street, Halifax Infirmary, Suite 355, Halifax, NS, B3H 3A7, CanadaTrauma Nova Scotia, Room 1-026B, Centennial Building, 1276 South Park Street, Halifax, NS, B3H 2Y9, CanadaPerformance Excellence, Nova Scotia Health Authority, Halifax, NS, B3H 4R2, CanadaDepartment of Critical Care, Dalhousie University, Suite 377, Bethune Building, 1276 South Park Street, Halifax, NS, B3H 2Y9, CanadaBackground. Patients with sepsis benefit from early diagnosis and treatment. Accurate paramedic recognition of sepsis is important to initiate care promptly for patients who arrive by Emergency Medical Services. Methods. Prospective observational study of adult patients (age ≥ 16 years) transported by paramedics to the emergency department (ED) of a Canadian tertiary hospital. Paramedic identification of sepsis was assessed using a novel prehospital sepsis screening tool developed by the study team and compared to blind, independent documentation of ED diagnoses by attending emergency physicians (EPs). Specificity, sensitivity, accuracy, positive and negative predictive value, and likelihood ratios were calculated with 95% confidence intervals. Results. Overall, 629 patients were included in the analysis. Sepsis was identified by paramedics in 170 (27.0%) patients and by EPs in 71 (11.3%) patients. Sensitivity of paramedic sepsis identification compared to EP diagnosis was 73.2% (95% CI 61.4–83.0), while specificity was 78.8% (95% CI 75.2–82.2). The accuracy of paramedic identification of sepsis was 78.2% (492/629, 52 true positive, 440 true negative). Positive and negative predictive values were 30.6% (95% CI 23.8–38.1) and 95.9% (95% CI 93.6–97.5), respectively. Conclusion. Using a novel prehospital sepsis screening tool, paramedic recognition of sepsis had greater specificity than sensitivity with reasonable accuracy.http://dx.doi.org/10.1155/2016/6717261 |
| spellingShingle | Robert S. Green Andrew H. Travers Edward Cain Samuel G. Campbell Jan L. Jensen David A. Petrie Mete Erdogan Gredi Patrick Ward Patrick Paramedic Recognition of Sepsis in the Prehospital Setting: A Prospective Observational Study Emergency Medicine International |
| title | Paramedic Recognition of Sepsis in the Prehospital Setting: A Prospective Observational Study |
| title_full | Paramedic Recognition of Sepsis in the Prehospital Setting: A Prospective Observational Study |
| title_fullStr | Paramedic Recognition of Sepsis in the Prehospital Setting: A Prospective Observational Study |
| title_full_unstemmed | Paramedic Recognition of Sepsis in the Prehospital Setting: A Prospective Observational Study |
| title_short | Paramedic Recognition of Sepsis in the Prehospital Setting: A Prospective Observational Study |
| title_sort | paramedic recognition of sepsis in the prehospital setting a prospective observational study |
| url | http://dx.doi.org/10.1155/2016/6717261 |
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