Josie, As a sepsis coordinator, my suggestions prehospital include two large bore IVs, having lab drawn (including gray top for lactate) and ready to handoff for laboratory analysis, and goal directed fluid resuscitation (using MAP, SBP, UO, etc. that is predetermined by your medical director). Broad spectrum antibiotics prior to physician assessment and cultures in my opinion is a step outside of your scope of practice a little too far.
Respectfully, Jamie Jamie Roney, BSN, RN-BC, BSHCM, CCRN COVENANT HEALTH SEPSIS COORDINATOR "Be a yardstick of quality. Some people aren't used to an environment where excellence is expected." ~Steve Jobs 3615 19th Street, Lubbock, TX 79410 T: (806) 725-4689 C: (806) 773-1914 www.covenanthealth.org ...................................................................................... -----Original Message----- From: [email protected] [mailto:[email protected]] On Behalf Of Josie Gray Sent: Monday, September 30, 2013 6:32 AM To: [email protected] Subject: [Sepsis Groups] Pre-hospital Antibiotic Administration Hi there, I am a third year student Paramedic, studying at the University of Brighton. An assignment we have been given involves researching and suggesting an improvement our local ambulance service can make to improve patient care. I recently attended a male suffering signs of severe sepsis. He had been getting progressively worse following an untreated chest infection and had been in the condition we found him for around 3 hours before his wife decided to call an Ambulance. We initiated a fluid challenge and took him to A&E under a blue light priority. Along with all our regular checks. My thoughts from this were, had paramedics been allowed to give broad spectrum antibiotics, would this have been of benefit to the patient at all as apposed to receiving these in hospital, considering his potential to deteriorate rapidly? Our transport time being 20-25 minutes. And would this have given the hospital more time to complete other tasks required for this patient, e.g blood cultures, imaging etc and enable him to get the care he needs as quickly as possible? I would be very grateful for your opinion on this and if you would have any suggestions or recommendations I could research into, on what more the Ambulance service can do for this group of patients? Kind Regards, Josie Gray Third year student Paramedic, University of Brighton. _______________________________________________ Sepsisgroups mailing list [email protected] http://lists.sepsisgroups.org/listinfo.cgi/sepsisgroups-sepsisgroups.org Notice from St. Joseph Health System: Please note that the information contained in this message may be privileged and confidential and protected from disclosure. _______________________________________________ Sepsisgroups mailing list [email protected] http://lists.sepsisgroups.org/listinfo.cgi/sepsisgroups-sepsisgroups.org
