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Prehospital recognition and antibiotics for 999 patients with sepsis : protocol for a feasibility study

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Moore, Chris, Bulger, Jenna, Morgan, Matt, Driscoll, Timothy, Porter, Alison, Islam, Saiful, Smyth, Michael A., Perkins, Gavin D., Sewell, Bernadette, Rainer, Timothy et al.
(2018) Prehospital recognition and antibiotics for 999 patients with sepsis : protocol for a feasibility study. Pilot and Feasibility Studies, 4 (1). 64. doi:10.1186/s40814-018-0258-8

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Official URL: http://dx.doi.org/10.1186/s40814-018-0258-8

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Abstract

Background: Sepsis is a common condition which kills between 36,000 and 64,000 people every year in the UK. Early recognition and management of sepsis has been shown to reduce mortality and improve the health and well-being of people with sepsis. Paramedics frequently come into contact with patients with sepsis and are well placed to provide early diagnosis and treatment. We aim to determine the feasibility of undertaking a fully powered randomised controlled trial (RCT) to test the clinical and cost-effectiveness of paramedics obtaining blood cultures from and administering IV antibiotics to patients with sepsis, so we can make a decision about whether to proceed to a fully powered randomised controlled trial, which will answer questions regarding safety and effectiveness for patients and benefit to the National Health Service (NHS).

Methods/design: This is an individually randomised, two-arm feasibility study for a randomised controlled trial with a 1:1 ratio. Sixty paramedics will receive training to assist them to recognise sepsis using a screening tool, obtain blood cultures, and provide IV antibiotics. If sepsis is suspected, paramedics will randomly allocate patients to intervention or usual care using their next sequential individually issued scratch card. Patients will be followed up at 90 days using linked anonymised data to capture length of hospital admission and mortality. We will also collect self-reported health-related quality of life (using SF-12) at this time. We will interview ten patients by telephone and hold a focus group with paramedics, to find out what they think about the intervention.

Discussion: At the end of this study, we will make a recommendation about whether a full randomised controlled trial of paramedics obtaining blood cultures and administering IV antibiotics for sepsis is warranted, and if so, we will develop a proposal for research funding in order to take the work forward. © 2018 The Author(s).

Item Type: Journal Article
Subjects: R Medicine > R Medicine (General)
Divisions: Faculty of Medicine > Warwick Medical School > Health Sciences > Clinical Trials Unit
Faculty of Medicine > Warwick Medical School > Health Sciences
Faculty of Medicine > Warwick Medical School
Library of Congress Subject Headings (LCSH): Septicemia -- Treatment, Emergency medicine -- Decision making, Emergency medical technicians, Septicemia -- Diagnosis, Antibiotics, Emergency medical services
Journal or Publication Title: Pilot and Feasibility Studies
Publisher: Springer Nature
ISSN: 2055-5784
Official Date: 12 March 2018
Dates:
DateEvent
12 March 2018Published
4 March 2018Accepted
Volume: 4
Number: 1
Article Number: 64
DOI: 10.1186/s40814-018-0258-8
Status: Peer Reviewed
Publication Status: Published
Access rights to Published version: Open Access
RIOXX Funder/Project Grant:
Project/Grant IDRIOXX Funder NameFunder ID
RfPPB 1191Health and Care Research Waleshttp://dx.doi.org/10.13039/100012068
Open Access Version:
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