I'm less concerned about field fluids than I am about field antibiotics, to be honest. I have also not been able to find any literature that supports the practice and, from an antimicrobial stewardship point, it seems a little "free and easy". It also feels a little "tick the box" rather than "treat the patient".
I get that there is a linear relationship with increased mortality and delay of appropriate antibiotic administration - but the key word here is, "appropriate". After nearly 20 years in the ED prior to critical care *(including a little time as a MICN - radio/protocols/base station RN)*, I'm pretty familiar with the scope of EMT-P practice and this doesn't seem to fall within it. If there is data, though, I would love to see it and be educated... Sam -- Sam Farrell, RN CCRN Intensivist Program Manager West Coast Critical Care Specialists office: 805.988.7004 fax: 805.988.7101 cell: 805.444.3730 wccriticalcare.com *CONFIDENTIALITY NOTICE : This message and any included attachments are intended only for the addressee and may contain confidential information belonging to the sender that is legally protected. Unauthorized forwarding, printing, copying, distribution, or use of such information is strictly prohibited and may be unlawful. If you are not the addressee, please promptly delete this message and notify the sender of the delivery error by e-mail. Thank you.* On Sun, Apr 16, 2017 at 6:52 AM, Jamie Natkowski <[email protected]> wrote: > Does anyone have concerns that we will be giving fluids unnecessarily > based on the EMS protocols? What will dictate when fluids are to be given > per protocol by ems? I am assuming the only parameter they will have to go > by is hypotension since they will not be diagnosing a suspected infection > and they will not have labs to use a lactate as an indication for fluids. I > have heard that ALL septic patients will get 20-30ml/kg per EMS standing > orders. I am sure this will vary greatly based on which department they > operate from. Thanks. > > On Mon, Apr 3, 2017 at 12:28 PM, Helsley, Anne <[email protected]> > wrote: > >> A local EMS is planning a protocol to screen for Severe Sepsis in the >> field pre-hospital. Based upon the screening results (which do not include >> a lactate), they will be administering crystalloid fluids, drawing blood >> cultures and giving a broad spectrum antibiotic. While I can find >> literature to support the fluid administration, I have been unable to find >> any support for the antibiotic administration. >> >> Are you familiar with this practice, is it happening in your area, or are >> you familiar with any literature to support/not-support. >> >> Thank you in advance. >> >> >> >> Anne Helsley MS, RN, CPHQ >> >> Health Informatics Specialist | Quality Management >> >> St. Mary’s Health >> >> 3700 Washington Avenue >> >> Evansville, IN 47750 >> >> 812.485.7925 <(812)%20485-7925> TEL | 812.485.7862 <(812)%20485-7862> FAX >> >> [email protected] <[email protected]%20> | www.stmarys.org >> >> >> >> [image: cid:[email protected]] >> >> *T**h**e Magnet Recognition Program®, ANCC Magnet Recognition® , Magnet® >> names and logos are registered trademarks of the American Nurses >> Credentialing Center. All rights reserved* >> >> >> >> CONFIDENTIALITY NOTICE: >> >> This email message and any accompanying data or files is confidential and >> may contain privileged information intended only for the named >> recipient(s). If you are not the intended recipient(s), you are hereby >> notified that the dissemination, distribution, and or copying of this >> message is strictly prohibited. If you receive this message in error, or >> are not the named recipient(s), please notify the sender at the email >> address above, delete this email from your computer, and destroy any copies >> in any form immediately. Receipt by anyone other than the named >> recipient(s) is not a waiver of any attorney-client, work product, or other >> applicable privilege. >> >> _______________________________________________ >> Sepsisgroups mailing list >> [email protected] >> http://lists.sepsisgroups.org/listinfo.cgi/sepsisgroups-sepsisgroups.org >> >> > > _______________________________________________ > Sepsisgroups mailing list > [email protected] > http://lists.sepsisgroups.org/listinfo.cgi/sepsisgroups-sepsisgroups.org > >
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