Approaches in Prehospital Sepsis Screening

Discussion In the United States, sepsis is one of the leading causes of death, which requires timely identification and proper treatment (CDC, 2019; Guerra et al., 2020; Polito et al., 2015). Based upon a review of literature conducted from 2014 to 2018, the primary investigators could locate five prehospital EMS screening tools to assist EMS providers in identifying at-risk sepsis patients. The researchers explored how the modified SIRS and qSOFA scoring systems were used in hospital settings in addition to these five prehospital EMS screening tools. The Bas 90-30-90, Guerra, PRESEP, PRESS, and Robson tools have overlapping screening protocol similarities. The PRESS score is a promising tool with an 86% sensitivity score; however, according to Polito et al. (2015), this tool needs to be duplicated and studied to validate externally. The Guerra protocol, which utilizes lactate testing, has a low sensitivity score (48%); thus, it is limiting since most EMS are not equipped with lactate testing capabilities.6 The Robson screening tool, which was adapted from the Surviving Sepsis Campaign diagnostic criteria, uses a modified system inflammatory response syndrome (SIRS) criterion.4 The Robson screening tool has a 93% sensitivity score, though it has yet to be further validated. While the BAS 90-30-90 has been used internationally, this tool lacks data and literature to support its application in a prehospital setting. Finally, the PRESEP score, derived from a retrospecti...
Source: JEMS Administration and Leadership - Category: Emergency Medicine Authors: Tags: Exclusives Patient Care EMS EMT Paramedic Prehospital Sepsis Source Type: news