Recognition of acute organ failure and associated fluid and oxygen resuscitation by emergency medical services of emergency department patients with a suspected infection.

Abstract

INTRODUCTION:

Recognition of acute organ failure is essential for recognition and resuscitation of sepsis by emergency medical services (EMS). We assessed how many EMS patients with suspected infection had clinical signs of acute organ failure (i.e. hypotension), received fluids and oxygen, and how many EMS patients without clinical signs of organ failure appeared to have organ failure in the emergency department (ED).

METHODS:

We interrogated an existing database in which consecutive ED patients hospitalized with suspected infection were prospectively collected. Outcomes were 1) number of patients without clinical signs of organ failure in the ambulance who developed clinical signs of organ failure or appeared to have biochemical signs of organ failure (i.e. hyperlactatemia) in the ED, and 2) number of patients who received fluids and oxygen in the ambulance.

RESULTS:

Of the 788 analyzed EMS patients, 529 (67.1%) had clinical signs of organ failure, of whom only 161 (30.4%) received fluids and 372 (70.3%) received oxygen. Clinical signs of organ failure were absent in 259 (32.9%) EMS patients, of which 165 patients (63.7%) developed organ failure in the ED.

CONCLUSIONS:

In patients with suspected infection, acute organ failure is poorly recognized and treated by EMS, partly because of delayed development of organ failure.

• Authors: Anne-Lize Amesz, Matthijs de Visser, Bas de Groot
• Journal: International emergency nursing (Int Emerg Nurs) Vol. 43 Pg. 92-98 (Mar 2019) ISSN: 1878-013X [Electronic] England
• PMID: 30514618 (Publication Type: Journal Article, Observational Study)
• Copyright: Copyright © 2018 Elsevier Ltd. All rights reserved.

Topics

• Adult
• Aged
• Cohort Studies
• Emergency Medical Services (methods, standards, statistics & numerical data)
• Emergency Service, Hospital (organization & administration, statistics & numerical data)
• Female
• Fluid Therapy (methods, standards, statistics & numerical data)
• Humans
• Infections (complications)
• Male
• Middle Aged
• Multiple Organ Failure (diagnosis, therapy)
• Netherlands
• Oxygen Inhalation Therapy (methods, standards, statistics & numerical data)
• Resuscitation (methods)