Sepsis Clinical Trial
Official title:
Physician Administered Antibiotics in a Prehospital Mobile Emergency Care Unit
Sepsis is estimated to affect more than 30 million people globally. Detecting sepsis is
notoriously difficult and there are no systems in place utilize prehospitally. In Denmark,
the Mobile Emergency Care Unit (the MECU), manned by a physician and paramedic, is able to
draw blood cultures and take venous lactate measurements before administering antibiotics.
This study aims to conduct a quality control on the ability of the MECU to recognize and
treat sepsis by confirming the amounts of in-hospitally diagnosed cases. Furthermore the
study investigates whether the blood cultures falls within an acceptable range of
contamination.
In Denmark, the Emergency Medical System (EMS) consists of not only ambulances operated by
paramedics and emergency technicians (EMTs) but also of Mobile Emergency Care Unit (MECU)
staffed with an emergency physician with specialist training in anesthesiology and a
paramedic. Only the physician on the MECU can administer prehospital antibiotics in Denmark;
this emphasizes the importance of the first responding emergency units' capability in
detecting and realizing the need for antibiotics in a patient so that the MECU can be
requested and treatment initiated quickly.
Determining the administration of antibiotics is done at the anesthesiologists' discretion.
The purpose of administering antibiotics prehospitally is to reduce the time gap between
suspicion of sepsis arises and the administration of antibiotics.
The purpose of this retrospective study is to conduct a quality control of the obtaining of
blood cultures and of the administration of antibiotics in the prehospital setting serviced
by the MECU in Odense in the Region of Southern Denmark in a time interval of 5 years
(November 2013- October 2018).
The primary purpose is to associate the prehospital tentative diagnosis (assigned by the
MECU) with the final diagnosis (ICD10 from hospital charts) including: 1: An indication for
antibiotic therapy and 2: An assessment of the feasibility and potential benefit of the blood
cultures obtained. 3: A description of the bacteria found in the blood cultures.
The association between initial prehospital diagnosis and final the diagnosis will be
compared.
Secondly the patients seen by the MECU will be characterized regarding diagnosis
(ICD10-classification), age, sex, medication, and the first set of vital parameters (Heart
rate, Blood pressure, Respratory rate, Oxygen saturation, Glasgow Coma Score, Temperature).
Hypothesis The indication for giving prehospital antibiotics is supported by the prehospital
blood culture and by additional findings reproduced inhospitally.
The prehospital tentative diagnosis is confirmed in-hospitally. Prehospital blood sampling is
associated with an acceptably low range of contamination.
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