Recognising and managing severe sepsis in the pre-hospital environment

Abstract

Severe sepsis is a complex medical condition in which the immune system overreacts to an infection leading to circulatory shock and organ failure. Patients with severe sepsis are critically ill and have a high mortality rate in the absence of early aggressive treatment, however, recognition and treatment of the condition remains poor. Recent improvements in the care of patients with myocardial infarction, stroke and multiple trauma have demonstrated how pre-hospital recognition and treatment can greatly improve outcomes for patients, and paramedics are well placed to provide similar improvements to the care of patients with severe sepsis. This article will explore the pathophysiology of sepsis, the recommended treatment bundles suggested by the ‘sepsis six campaign’ and the difficulties faced in implementing such treatments. Finally, it will explore the interventions that could be undertaken by Paramedics to improve patient care.