South Carolina EMS Integrates In-Hospital Sepsis Care into Protocols

Medic 29 is dispatched to a college dorm for a female with chief complaint of lower abdominal and flank pain for the past five days. The dorm room appears clean and well kept. The patient appears to be a typical 18-year-old college student. She's lying on her bed and is responsive to verbal stimuli, hot to touch, and tachycardic with weak and thready radial pulses at 128. She reports painful urinating for the past 48 hours, general malaise, weakness and nausea. She appears to have labored respirations with a room air SpO2 reading of 95% and is hypotensive with a systolic blood pressure of 88 mmHg that remains low during transport to the ED. Oxygen is applied at 15 Lpm and IV access is obtained via a 16-gauge catheter with 800 mL of normal saline administered en route. The working diagnosis in the ED is septic shock secondary to a urinary tract infection. A central line is placed and norepinephrine and IV antibiotics are started while the patient is moved to the ICU. Over the course of two days, the patient's shock is refractory to treatment leading to multisystem organ failure and the patient's death. Background Advancements in prehospital care for cardiac arrest, ST elevation myocardial infarction (STEMI) and acute stroke have demonstrated the vital role that EMS has in the identification and early intervention in these life-threatening conditions. One disease that's been overlooked for some time is sepsis; more importantly, severe sepsis and septic shock. Severe sepsis is r...
Source: JEMS Patient Care - Category: Emergency Medicine Authors: Tags: Patient Care Source Type: news