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Original research
Care of the patient with invasive meningococcal disease by prehospital emergency medical service clinicians: a scoping review
  1. James Pearce1,2,
  2. Micah Peters3,
  3. Nikki May4,
  4. Helen Marshall5,6,
  5. Cindy Hein1,2,
  6. Hugh Grantham2,7
  1. 1College of Medicine and Public Health, Flinders University, Bedford Park, South Australia, Australia
  2. 2South Australian Ambulance Service, Adelaide, South Australia, Australia
  3. 3Rosemary Bryant AO Research Centre, School of Nursing and Midwifery, University of South Australia, Adelaide, South Australia, Australia
  4. 4SA Health Library Service, Bedford Park, South Australia, Australia
  5. 5School of Medicine and Robinson Research Institute, The University of Adelaide, Adelaide, South Australia, Australia
  6. 6Vaccinology and Immunology Research Trials Unit, Discipline of Paediatrics, Women's and Children's Hospital Adelaide, North Adelaide, South Australia, Australia
  7. 7Faculty of Health Sciences, School of Nursing, Midwifery and Paramedicine, Curtin University, Perth, Western Australia, Australia
  1. Correspondence to Mr James Pearce; james.pearce{at}


Objective The objective of this scoping review is to systematically map the literature to identify the scope, depth, key concepts and gaps in the evidence regarding care of the patient with invasive meningococcal disease by emergency medical service (EMS) clinicians.

Design Scoping review. This review is reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews reporting guideline.

Eligibility criteria Sources which focused on patients with invasive meningococcal disease (population), where the care of EMS clinicians was the focus (concept), in EMS systems worldwide (context) were eligible for inclusion.

Search strategy This review utilised a comprehensive search strategy including MEDLINE, Embase, Emcare, CINAHL, Scopus, Web of Science, Google Scholar and ‘grey’ literature databases from 1992 to January 2019. The search also included a Google search, a hand-search of relevant journals, screening of reference lists, contact with authors of included sources and use of social media in an attempt to locate all sources of evidence which fit the inclusion criteria of the review. Two reviewers independently screened sources for inclusion.

Results The search yielded 1803 unique records, of which 10 were included in the synthesis. No original research papers were identified, with all sources classed as either clinical audit or text and opinion literature. The dominant concept throughout the literature is that early antibiotic therapy is critical in the treatment of invasive meningococcal disease.

Conclusions Overall, there is a very narrow scope and shallow depth of literature on the topic of interest. There are gaps in the evidence regarding the care of the patient with invasive meningococcal disease by EMS clinicians. Despite these shortfalls, current consensus-based guidelines should direct clinical practice. Further research is planned to bridge the gaps in knowledge to support best practice.

  • ambulance
  • emergency medical services
  • meningococcal disease
  • scoping review
  • sepsis

This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See:

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  • Contributors JP is the study guarantor and conceived the study, developed the search strategy, assisted in the searches, screened the studies, extracted and interpreted the data and drafted and revised the manuscript. MP contributed towards the design of the study and critically reviewed and revised the draft manuscript. NM assisted in developing the search strategy, performed the searches and assisted in manuscript revisions. HM, CH and HG contributed towards the design of the study, interpretation of the data and edited the draft manuscript. All authors read and approved the final manuscript.

  • Funding JP receives an Australian Government Research Training Program Scholarship and was partly financially supported by a National Health and Medical Research Council PhD scholarship through the Pre-hospital Emergency Care - Australia New Zealand (PEC-ANZ) Centre for Research Excellence (ID:1116453). Funding had no influence on this manuscript.

  • Competing interests MP declares that he is co-author of the PRISMA Extension for Scoping Reviews (PRISMA-ScR) paper, and that he is the Chair of the Joanna Briggs Institute Methodology Group for Scoping Reviews. All other authors declare that there are no known conflicts of interest.

  • Patient consent for publication Not required.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data availability statement The data analysis of included sources can be accessed upon request by emailing the corresponding author (

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