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Prehospital suspicion and identification of adult septic patients:Experiences of a screening tool
University of Borås, Faculty of Caring Science, Work Life and Social Welfare. (PreHospen)
University of Borås, Faculty of Caring Science, Work Life and Social Welfare. (PreHospen)
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2016 (English)Conference paper, Abstract (Refereed)
Abstract [en]

Introduction:  Sepsis  is life threatening  and  requires  urgent healthcare  to reduce  suffering  and death. Therefore it is important that septic patients are identified early to enable treatment.

 

Aim: To investigate to what extent EMS personnel identified patients with sepsis using the "BAS

90-30-90"  model, and to describe assessments and medical procedures that were  undertaken by the personnel.

 

Methods: This was a retrospective study where  185 EMS medical records were  reviewed. The inclusion was based on patients who were later diagnosed with sepsis in the hospital.

 

Results: A physician assessed the patients  in 74 of the EMS cases, which lead to exclusion  of these  records  in  regard  to  the  EMS  personnel's  ability  to  identify  sepsis.  The  personnel documented  suspicion  of severe sepsis in eight (n=8) of the remaining 111 records (7.2%). The proportion  of patients  065 years  of age was 73% (n=135)  of which  37% (n=50) were over 80 years  old. Thirty-nine percent  (39%,  n=72)  were  females. The  personnel  documented blood pressure   in  91%  (n=168),  respiratory   rate  in  76%  (n=140),   saturation   in  100%  (n=185), temperature  in 76%  (n=141),  and  heart  rate  in  94%  (n=174)  of  the  records.  Systolic  blood pressure  <90 mmHg  was  documented  in 14,2%  (n=24),  respiratory  rate  030 in 36%  (n=50), saturation <90 in 49%   (n=91). temperature >38°C in 37.6% (n=53), and heart rate 090 in 70% (n=121) of the records. Documented medical procedures and treatments were intravenous  lines (70%, n=130), intravenous  fluids (10%, n=19) and administration  of oxygen (72%, n=133).

 

Conclusion:  The EMS personnel identified  only a few septic patients  with the help of the BAS

90-30-90  model when  all three criteria  would  be met for severe  sepsis. Either  advanced age (>65  years),   fever   (>38°C)   or  tachypnea (020  breaths/min)   appeared   to   increase  the personnel's suspicion  of sepsis. Oxygen, but not intravenous  fluids, was given in an adequate way.

Place, publisher, year, edition, pages
2016.
Keyword [en]
Sepsis, Assessment, Screening tool, Medical record review
National Category
Nursing
Identifiers
URN: urn:nbn:se:hb:diva-10675OAI: oai:DiVA.org:hb-10675DiVA: diva2:967827
Conference
2nd Global Conference on Emergency Nursing & Trauma Care, Sitges (Spain) September 22 - 24, 2016
Available from: 2016-09-09 Created: 2016-09-09 Last updated: 2017-05-04Bibliographically approved

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