Journal article
Opportunities for achieving resuscitation goals during the inter-emergency department transfer of severe sepsis patients by emergency medical services: A case series
Journal of critical care, Vol.52, pp.163-165
08/2019
DOI: 10.1016/j.jcrc.2019.04.017
PMCID: PMC6995664
PMID: 31078996
Abstract
This study aimed to describe the care provide by Emergency Medical Services (EMS) to severe sepsis patients being transferred between acute care hospitals and identify how that care contributes to sepsis care goals.
This was a single-center retrospective cohort study conducted at a 60,000-visit Midwestern academic emergency department, using run reports from 13 ambulance services transferring from 9 hospitals.
39 patients were included in the final cohort, transferred by 13 ambulance services from 9 hospitals. Included patients were adults with severe sepsis transferred by ambulance between 2009 and 2014. Thirty-nine patients were included in this cohort. 41% (n = 12) of patients received an adequate fluid bolus of 30 mL/kg (median 42.9 mL/kg crystalloid fluid, IQR 8.0 mL/kg) prior to tertiary care arrival. Seventeen percent (n = 2) of patients completed the adequate bolus during transfer time. Broad-spectrum antibiotics were initiated during transfer in 2 patients.
EMS sepsis care during transfer was limited. EMS crews primarily continued treatments previously initiated and did not take additional steps toward resuscitation targets. Data suggests the inter-emergency department transfer period may provide an opportunity to continue working toward treatment targets, though the time is currently underutilized.
•Sepsis care goals in inter-facility transfer patients are often not met.•The inter-hospital transfer period is currently underutilized.•Antibiotic administration can present challenges in transfer patients.•EMS providers have skills necessary to contribute to sepsis care.
Details
- Title: Subtitle
- Opportunities for achieving resuscitation goals during the inter-emergency department transfer of severe sepsis patients by emergency medical services: A case series
- Creators
- Adam Froehlich - Department of Emergency Medicine, University of Iowa Hospitals and Clinics, 220 Hawkins Dr, Iowa City, IA 52242, United StatesRyan J Tegtmeier - Department of Emergency Medicine, University of Iowa Hospitals and Clinics, 220 Hawkins Dr, Iowa City, IA 52242, United StatesBrett A Faine - Department of Emergency Medicine, University of Iowa Hospitals and Clinics, 220 Hawkins Dr, Iowa City, IA 52242, United StatesJennifer Reece - Department of Emergency Medicine, University of Iowa Hospitals and Clinics, 220 Hawkins Dr, Iowa City, IA 52242, United StatesAzeemuddin Ahmed - Department of Emergency Medicine, University of Iowa Hospitals and Clinics, 220 Hawkins Dr, Iowa City, IA 52242, United StatesNicholas M Mohr - Department of Emergency Medicine, University of Iowa Hospitals and Clinics, 220 Hawkins Dr, Iowa City, IA 52242, United States
- Resource Type
- Journal article
- Publication Details
- Journal of critical care, Vol.52, pp.163-165
- DOI
- 10.1016/j.jcrc.2019.04.017
- PMID
- 31078996
- PMCID
- PMC6995664
- NLM abbreviation
- J Crit Care
- ISSN
- 0883-9441
- eISSN
- 1557-8615
- Publisher
- Elsevier Inc
- Grant note
- K08HS025753 / Agency for Healthcare Research and Quality (https://doi.org/10.13039/100000133) University of Iowa (https://doi.org/10.13039/100008893)
- Language
- English
- Date published
- 08/2019
- Academic Unit
- Management and Entrepreneurship ; Epidemiology; Emergency Medicine; Pharmacy Practice and Science; Anesthesia; Injury Prevention Research Center
- Record Identifier
- 9984024501202771
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