Article Text

Download PDFPDF

4 Prehospital recognition and antibiotics for 999 patients with sepsis: protocol for a feasibility study
  1. Chris Moore1,
  2. Jenna Bulger2,
  3. Matt Morgan3,
  4. Timothy Driscoll1,
  5. Alison Porter1,
  6. Saiful Islam1,
  7. Mike Smyth4,
  8. Gavin Perkins4,
  9. Bernadette Sewell2,
  10. Timothy Rainer3,
  11. Prabath Nanayakkara5,
  12. Chukwudi Okolie2,
  13. Susan Allen3,
  14. Greg Fegan2,
  15. Jan Davies6,
  16. Theresa Foster7,
  17. Nick Francis3,
  18. Fang Gao Smith8,
  19. Gemma Ellis3,
  20. Tracy Shanahan3,
  21. Robin Howe9,
  22. Samuel Ricketts1,
  23. Helen Snooks2
  1. 1Welsh Ambulance Services NHS Trust, UK
  2. 2Swansea University, UK
  3. 3Cardiff and Vale University Health Board, UK
  4. 4University of Warwick, UK
  5. 5VU University Medical Centre, Netherlands
  6. 6Patient Representative, UK
  7. 7East of England Ambulance Service NHS Trust, UK
  8. 8University of Birmingham, UK
  9. 9Public Health UK


Aim Sepsis is common; it kills at least 44 000 people every year in the UK. Early recognition and management of sepsis has been shown to reduce morbidity and mortality of people with sepsis. Paramedics frequently come into contact with patients with sepsis, and are well placed to provide early treatment. This feasibility study aims to find out whether paramedics can collect blood cultures from and administer intravenous (IV) antibiotics to patients with sepsis. We will determine the feasibility, safety and acceptability of our trial design and data collection methods.

Method Paramedics will receive training to assist them to recognise sepsis using a screening tool, obtain blood cultures, and provide IV antibiotics. If sepsis is suspected, paramedics will randomly allocate patients to intervention or usual care using scratchcards. Patients will be followed up at 90 days using linked anonymised data to capture length of hospital admission and mortality. We will also collect self-reported health-related quality of life at this time. We will interview ten patients and hold a focus group with paramedics, to find out what they think about the intervention.

Results An intervention development group agreed upon the clinical protocol and training methods. Sixty paramedics have been trained. Patient recruitment will commence 1 st December 2017.

Conclusion At the end of this study we will make a recommendation about whether a fully-powered randomised controlled trial is warranted, and if so, we will develop a proposal for further research funding to answer questions regarding safety and effectiveness for patients, and benefit to the National Health Service.

Conflict of interest None

Funding PhRASe was funded by Health and Care Research Wales, Grant 1191. Chris Moore is the Chief Invesitgator.

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:

Statistics from

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.