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The following is a summary of the study “Performance of screening tools and use of blood analyses in prehospital identification of sepsis patients and patients suitable for non-conveyance – an observational study,” published in the October 2024 issue of Emergency Medicine by Olander et al.
Early detection of sepsis by Emergency Medical Services (EMS) is critical for improving patient outcomes. However, identifying sepsis in prehospital settings remains difficult, and the effectiveness of screening tools and blood tests in this context is not well understood.
A team of researchers aimed to evaluate the performance of various sepsis screening tools used by EMS personnel and assess whether incorporating blood tests could improve sepsis identification and enhance patient outcomes. They conducted a retrospective observational cohort study that analyzed patient demographics, vital signs, and blood test results. They employed statistical methods, including the Student’s t-test, to assess the screening tools’ sensitivity, specificity, and predictive values.
Among the 5,405 EMS missions evaluated involving 3,225 unique patients, sepsis was confirmed in 9.8% of cases. None of the eleven screening tools used demonstrated high sensitivity and specificity for sepsis identification. White blood cell (WBC) count had the highest sensitivity but lowest specificity for detecting sepsis. Adding WBC, C-reactive protein (CRP), or lactate to the National Early Warning Score (NEWS) improved specificity to over 80%, but this significantly reduced sensitivity.
The study concluded that prehospital sepsis identification continues to be challenging, with existing screening tools showing limited accuracy. While blood tests such as CRP, WBC, and lactate improve specificity, their overall predictive value for sepsis and non-conveyance decisions remains minimal.
Source: bmcemergmed.biomedcentral.com/articles/10.1186/s12873-024-01098-4
