Abstract
BackgroundThe initial care of patients with sepsis is commonly performed by ambulance clinicians (ACs). Early identification, care and treatment are vital for patients with sepsis to avoid adverse outcomes. However, knowledge about how patients with sepsis are assessed in ambulance services (AS) by AC is limited. Therefore, the aim of this study was to explore the meaning of ACs’ lived experiences in assessing patients suspected of having sepsis.MethodsA descriptive design with a qualitative approach was used. Fourteen ACs from three Swedish ambulance organizations participated in dyadic and individual semistructured interviews. A thematic analysis based on descriptive phenomenology was performed.ResultsAC experiences were grouped into four themes: (1) being influenced by previous experience; (2) searching for clues to the severity of the patient’s condition; (3) feeling confident when signs and symptoms were obvious; and (4) needing health-care professionals for support and consultation.ConclusionsThis study indicates that several factors are important to assessments. ACs needed to engage in an ongoing search for information, discuss the cases with colleagues and reconsider the assessment throughout the entire ambulance mission. A reflective and open stance based on professional knowledge could contribute to recognizing patients with sepsis.
Highlights
The initial care of patients with sepsis is commonly performed by ambulance clinicians (ACs)
Previous studies have indicated that a documented suspicion of sepsis in the ambulance services (AS) electronic health records shortened the time until the administration of antibiotics [5, 7], which is important because a delayed time to the start of antibiotics is associated with increased progression to septic shock and increased mortality [9]
The assessment was influenced by their previous experiences of meeting patients with sepsis, observations of the patients’ course of the disease, and the extent to which their suspicion was supported by guidelines or other health care professionals
Summary
The initial care of patients with sepsis is commonly performed by ambulance clinicians (ACs). Care and treatment are vital for patients with sepsis to avoid adverse outcomes. The initial care and treatment of patients with sepsis is vital for reducing adverse outcome risks due to inadequate assessments or delayed medical interventions [7]. Early suspicion of sepsis could lead to an assessment that can improve the patient’s prognosis and outcome [7, 8]. Previous studies have indicated that a documented suspicion of sepsis in the AS electronic health records shortened the time until the administration of antibiotics [5, 7], which is important because a delayed time to the start of antibiotics is associated with increased progression to septic shock and increased mortality [9]. Research has indicated a large variation in the proportion
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