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EMS plays critical role in sepsis prevention

Steven Simpson, MD, pulmonology and critical care

Sepsis facts

  • More than 500 people in the U.S. die from sepsis every day. 
  • Sepsis is the most common cause of death among noncoronary ICU patients. 
  • Sepsis is one of the most common causes of death in nursing homes.

SIRS criteria

  • Temperature > 38°C (100°F) or
    < 36°C (96.8°F)
  • Heart rate > 90 beats per minute (tachycardia)
  • Respiratory rate > 20 breaths per minute (tachypnea)

Stages of sepsis

  • Infection inflammatory response to microorganisms or invasion of normally sterile tissues
  • SIRS (systematic inflammatory response syndrome), a systemic response to a variety of processes
  • Sepsis infection plus two or more SIRS criteria
  • Severe sepsis plus organ dysfunction
  • Septic shock sepsis plus hypotension despite fluid resuscitation

Sepsis is common and often deadly. Despite medical advances like vaccines, antibiotics and intensive care, it is the primary cause of death from infection. Early recognition is crucial.

EMS professionals can help prevent sepsis infection or death by knowing the risk factors, identifying the symptoms and providing prompt treatment on the way to the hospital.

Sepsis is most often caused by bacterial infections or a weakened immune system. It can result from something as seemingly harmless as a scraped knee or nicked cuticle. Infants, the elderly and people with suppressed immune systems are at greatest risk.

Identifying sepsis: It's critical to recognize sepsis and act quickly to prevent death. As soon as sepsis causes organ dysfunction, mortality increases from 5 to 30 percent or more. There is no single diagnostic test for sepsis, such as measuring troponin (blood proteins) to diagnose myocardial infarction.

White blood cell count, a criterion of SIRS, is not usually available in the field. Point-of-care lactates can help determine the severity of sepsis. Other symptoms may include a dysfunctional organ, altered mental status or hypoxemia. At the scene with the patient, use the SIRS (systematic inflammatory response syndrome) criteria to help identify sepsis.

Family and friends can help: People at the scene can provide valuable information to help identify sepsis. Ask if the patient has had recent surgery, if there are any wounds and what medications the patient takes.

Fast treatment is crucial: In the ambulance, administer IV crystalloid fluid boluses and broad-spectrum IV antibiotic. Mortality rates for septic shock are 60 to 80 percent. Antibiotics within the first hour may reduce mortality to less than 10 percent. Notify the hospital if you have a sepsis patient and collect blood cultures.

To learn more about sepsis, visit kumed.com/sepsis.