If you don’t take a temperature, you can’t find a fever

Abstract

Sepsis and septic shock are common diseases with high mortality rates and a survival rate that decreases with every hour of delayed therapy. While definitions are valid and published, even the best sepsis score is not helpful if the criteria are not measured regularly in case of suspected sepsis. The objective of this retrospective study was to evaluate the documentation addressing vital signs in case of severe infection, which can be measured by emergency medical services (EMS) to detect suspected sepsis or septic shock during prehospital management. We screened 68,798 prehospital operation protocols of a German EMS district from January 1, 2013, to December 31, 2014. Tracer diagnoses were prehospital diagnoses of pneumonia, meningitis or septic shock. Those protocols (n = 1390) with severe infections as the leading diagnosis were identified. Respiratory rate was documented in 31.5% and temperature in 26.2%. The best documentation was found for heart rate (97.2%). There were significant differences in the documentation of vital signs between the different diagnoses (p < 0.001). The results show a lack of documentation in patients with infection. This finding is obvious from the data on respiratory rate and temperature. Considering that defined vital signs are among the criteria to diagnose sepsis, EMS personnel should be trained to measure and document fundamental vital signs and to search for signs of impending sepsis. This article was selected as “Editors pick” and is therefore available as Free Access.