Articles That May Change Your Practice: Prehospital Antibiotics

Abstract

Sepsis is the result of the body's dysregulated immune response to an infection, which can rapidly lead to multiorgan failure and death. Mortality can be as high as 35% and is highly dependent on the time interval between the onset of symptoms and treatment. The evidence suggests that early diagnosis of sepsis and early administration of intravenous antibiotics, as part of a bundle of care, can reduce morbidity and mortality from sepsis. The recognition of sepsis in the prehospital and transport setting before the patient's arrival in the hospital can speed up diagnostics and treatment upon arrival. Given that up to 50% of patients with sepsis arrive in the emergency department (ED) by ambulance, prehospital personnel have an opportunity to provide time-sensitive therapies in transport. The same holds true for patients with severe sepsis and septic shock who undergo interfacility transport from smaller hospitals to specialized centers of excellence. Russell D. MacDonald, MD, MPH, FCFP, FRCPC, is the medical director at Ornge Transport Medicine; medical director at Toronto Paramedic Services; an associate professor in the Faculty of Medicine at the University of Toronto; and an attending staff member at Sunnybrook Health Sciences Centre in Toronto, Ontario, Canada. He can be reached at .