Does level of training predetermine the success rate of prehospital sepsis assessment? A prospective survey on early recognition

Abstract

Sepsis is a challenge for health professionals. The increasing number of cases emphasizes the importance of early recognition resulting in better survival. Questionnaires were spread focusing on the prehospital recognition, treatment, and care pathway of septic patients. After presenting an initial scenario, other sepsis-like diseases were given as diagnosis of choice and the answers were registered. After redefining the situation, the same potential diagnoses were given and the difference in correct answers was detected. The number of responders was 120. Among them, 33% of responders chose hypovolaemia, 10% allergic reaction, 2.5% endocrine disease, 30.8% systemic inflammatory response syndrome/sepsis, 0.83% internal bleeding, 0.83% drug effect, 2.5% pulmonary embolism, and 19.17% metabolic disorder as primary diagnosis with a significantly higher number of trained paramedics highlighting the correct answer. After redefining the scenario, 63% changed the diagnosis, while 37% did not change (p < .001). Further management was correctly chosen by the majority of responders. The small number of correct answers from non-paramedics highlights the need for more education in identifying the pitfalls of early recognition and therapy of those who attend patients first. Trained paramedics recognize the sepsis better than other representatives, necessitating the introduction of new guidelines.