University of Lynchburg DMSc Doctoral Project Assignment Repository

University of Lynchburg DMSc Doctoral Project Assignment Repository




Dr. Tom Colletti



Purpose: Early appropriate antimicrobial therapy and intravenous (IV) fluids are crucial in patients with sepsis and septic shock. Studies often focus on the first dose of appropriate antibiotics and IV fluids when a patient has already arrived in the hospital or the emergency department (ED), but prehospital treatment is significantly and equally important. This study’s aim is to investigate the early treatment of sepsis with a focus on prehospital treatment and resuscitation of sepsis and severe sepsis.

Methods: A comprehensive literature search was conducted with PubMed, MEDLINE, and Cochrane Library with search terms, prehospital treatment, sepsis, severe sepsis, sepsis shock, antibiotics, and IV fluids. Most of the studies utilized in the literature review were published within the last five years and were limited to articles in the English language. About twelve relevant articles were reviewed and served as the basis for this clinical review.

Results: There was a good variety in the outcome measures reported in the different studies reviewed. Because of these differences, there was inconsistent evidence-based research to show that treating sepsis with antibiotics or IV fluids early in the prehospital phase reduced fatality rates.

Conclusion: Early detection and treatment of sepsis are essential for effective sepsis management. Although prehospital recognition and treatment by emergency medical services (EMS) personnel may provide a valuable opportunity for sepsis recognition and care, there is little evidence that prehospital antibiotics and fluid resuscitation improve patient outcomes significantly.

Keywords: Sepsis, Severe Sepsis, Septic Shock, Prehospital Recognition, Treatment of Sepsis


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