Impact of Prehospital Care on Outcomes in Sepsis: A Systematic Review

Autor: Gavin D. Perkins, Samantha J. Brace-McDonnell, Michael Smyth
Jazyk: angličtina
Rok vydání: 2016
Předmět:
medicine.medical_specialty
Emergency Medical Services
Time Factors
Psychological intervention
MEDLINE
lcsh:Medicine
CINAHL
Cochrane Library
law.invention
03 medical and health sciences
0302 clinical medicine
Randomized controlled trial
law
Sepsis
Outcome Assessment
Health Care
medicine
Emergency medical services
Humans
030212 general & internal medicine
Intensive care medicine
business.industry
lcsh:R
lcsh:Medical emergencies. Critical care. Intensive care. First aid
030208 emergency & critical care medicine
lcsh:RC86-88.9
General Medicine
Prognosis
United States
Systematic review
Emergency medicine
Practice Guidelines as Topic
Emergency Medicine
Prehospital Care
Observational study
Systematic Review
Guideline Adherence
sepsis
septic shock
Emergency Medical Services
prehospital
paramedic
business
RC
Zdroj: Western Journal of Emergency Medicine
Western Journal of Emergency Medicine, Vol 17, Iss 4, Pp 427-437 (2016)
Smyth, Michael A.; Brace-McDonnell, Samantha J.; & Perkins, Gavin D.(2016). Impact of Prehospital Care on Outcomes in Sepsis: A Systematic Review. Western Journal of Emergency Medicine, 17(4). doi: 10.5811/westjem.2016.5.30172. Retrieved from: http://www.escholarship.org/uc/item/2gw6g83b
ISSN: 1936-9018
1936-900X
DOI: 10.5811/westjem.2016.5.30172.
Popis: Introduction: Sepsis is a common and potentially life-threatening response to an infection. International treatment guidelines for sepsis advocate that treatment be initiated at the earliest possible opportunity. It is not yet clear if very early intervention by ambulance clinicians prior to arrival at hospital leads to improved clinical outcomes among sepsis patients. Methods: We systematically searched the electronic databases MEDLINE, EMBASE, CINAHL, the Cochrane Library and PubMed up to June 2015. In addition, subject experts were contacted. We adopted the GRADE (grading recommendations assessment, development and evaluation) methodology to conduct the review and follow PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) recommendations to report findings. Results: Nine studies met the eligibility criteria – one study was a randomized controlled trial while the remaining studies were observational in nature. There was considerable variation in the methodological approaches adopted and outcome measures reported across the studies. Because of these differences, the studies did not answer a unique research question and meta-analysis was not appropriate. A narrative approach to data synthesis was adopted. Conclusion: There is little robust evidence addressing the impact of prehospital interventions on outcomes in sepsis. That which is available is of low quality and indicates that prehospital interventions have limited impact on outcomes in sepsis beyond improving process outcomes and expediting the patient’s passage through the emergency care pathway. Evidence indicating that prehospital antibiotic therapy and fluid resuscitation improve patient outcomes is currently lacking.
Databáze: OpenAIRE
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