title: Severe sepsis and septic shock in pre-hospital emergency medicine: survey results of medical directors of emergency medical services concerning antibiotics, blood cultures and algorithms.
abstract: Delayed antibiotic treatment for patients in severe sepsis and septic shock decreases the probability of survival. In this survey, medical directors of different emergency medical services (EMS) in Germany were asked if they are prepared for pre-hospital sepsis therapy with antibiotics or special algorithms to evaluate the individual preparations of the different rescue areas for the treatment of patients with this infectious disease. The objective of the survey was to obtain a general picture of the current status of the EMS with respect to rapid antibiotic treatment for sepsis. A total of 166 medical directors were invited to complete a short survey on behalf of the different rescue service districts in Germany via an electronic cover letter. Of the rescue districts, 25.6 % (n = 20) stated that they keep antibiotics on EMS vehicles. In addition, 2.6 % carry blood cultures on the vehicles. The most common antibiotic is ceftriaxone (third generation cephalosporin). In total, 8 (10.3 %) rescue districts use an algorithm for patients with sepsis, severe sepsis or septic shock. Although the German EMS is an emergency physician-based rescue system, special opportunities in the form of antibiotics on emergency physician vehicles are missing. Simultaneously, only 10.3 % of the rescue districts use a special algorithm for sepsis therapy. Sepsis, severe sepsis and septic shock do not appear to be prioritized as highly as these deadly diseases should be in the pre-hospital setting.
authors.affiliation: Center for Critical and Emergency Care, Department of Anesthesiology, Intensive Care and Pain Management, Hospital of Main-Taunus-District, Teaching Hospital of J.-W. Goethe University Medical School, Kronberger Str. 36, 65812, Bad Soden, Germany. scasu@kliniken-mtk.de.
authors.forename: Sebastian
authors.initials: S
authors.lastname: Casu
authors.affiliation: Faculty of Medicine, Eberhard Karls University Tübingen, Geissweg 5, 72076, Tuebingen, Germany.
authors.forename: David
authors.initials: D
authors.lastname: Häske
mesh_terms: D000465:Algorithms; D000552:Ambulances; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D000071997:Blood Culture; D004632:Emergency Medical Services; D004638:Emergency Treatment / Q000592:standards*; D005858:Germany; D006801:Humans; D018805:Sepsis / Q000382:microbiology / Q000628:therapy*; D012772:Shock, Septic / Q000382:microbiology / Q000628:therapy*; D011795:Surveys and Questionnaires
chemical_list: D000900:Anti-Bacterial Agents
keywords: Algorithm; Antibiotics; Emergency medical services; Emergency treatment; Infection; Sepsis