Field Paramedic Application of Sepsis Triage

• Conditions: Sepsis

• Registration Number: NCT03870789
• Lead Sponsor: Hamilton Health Sciences Corporation

Brief Summary

Given the implementation of the Hamilton Early Warning Score (HEWS) and the use of capnography by paramedics, this study will involve a large multi-site retrospective evaluation (before vs after implementation) of the HEWS score and comparison of the HEWS to systemic inflammatory response syndrome (SIRS), quick Sepsis Related Organ failure Assessment (qSOFA) and Modified Early Warning Score (MEWS) when applied retrospectively for the identification of sepsis in the prehospital setting.

Detailed Description

1. To determine the accuracy of the HEWS score, compared to qSOFA, and SIRS for early sepsis recognition when used in the prehospital setting by paramedics for the identification of patients with sepsis or suspected sepsis.

2. To evaluate the addition of ETCO2 values to predict mortality in patients who screen positive for sepsis.

3. To identify the before and after healthcare outcomes of a prehospital sepsis alert program.

Study Timeline

• Study Start: 2016-12-11
• Status Verified: 2019-03
• Study First Submitted: 2019-03-08
• Study First Submitted QC: 2019-03-08
• Last Update Submitted: 2019-03-08
• Study First Posted: 2019-03-12
• Last Update Posted: 2019-03-12
• Primary Completion: 2019-05-01
• Study Completion: 2019-12-31

Recruitment & Eligibility

• Status: UNKNOWN
• Sex: All
• Target Recruitment: 400

Inclusion Criteria

Any patient to which paramedics apply the Hamilton Early Warning Score or patients who arrive to the Emergency Department (ED) by ambulance without a pre-alert and meet the definition of sepsis in the ED will also be included, and patient is ≥ 18 years

Exclusion Criteria

Patient is an inter-facility transfer, or patients with absent vital signs are absent, or death before blood can be drawn in the Emergency Department, or the patient fits the criteria for another prehospital alert (ST-elevation myocardial infarction, cerebrovascular vascular accident, or trauma)

Study & Design

• Study Type: OBSERVATIONAL
• Study Design: Not specified

Primary Outcome Measures

Name	Time	Method
Accuracy of HEWS	1 year	To determine the accuracy of the HEWS score, compared to qSOFA, and SIRS for early sepsis recognition when used in the prehospital setting by paramedics for the identification of patients with sepsis or suspected sepsis.

Secondary Outcome Measures

Name	Time	Method
Evaluate the addtion of end-tidal carbon dioxide (ETCO2) values	1 year	To evaluate the addition of ETCO2 values to predict mortality in patients who screen positive for sepsis.
Evaluate sepsis alert program	2 years	To identify the before and after healthcare outcomes of a prehospital sepsis alert program.

Trial Locations

Locations (1)

Centre for Paramedic Education and Research, Hamilton Health Sciences; 🇨🇦 Hamilton, Ontario, Canada