Drs. Jim Christenson, Laurie Morrison, Rob Stenstrom have recently published Prehospital antibiotics and intravenous fluids for patients with sepsis: protocol for a 2×2 factorial randomised controlled trial. In their research, they found that quickly recognizing and treating patients with sepsis can significantly improve survival rates. Unfortunately, patients taken to the hospital with sepsis often don’t receive treatment until they are evaluated in the emergency department. By starting treatments at the first point of contact, paramedics may be able to improve the outcomes for these patients.
Publication Title
Prehospital antibiotics and intravenous fluids for patients with sepsis: protocol for a 2×2 factorial randomised controlled trial (BMJ Open, 2025)
Abstract
The study design involves two randomised controlled trials (RCTs) conducted using a 2×2 factorial design comparing use of (1) early intramuscular ceftriaxone versus placebo and (2) an early liberal intravenous fluid strategy (up to 2 L normal saline) versus usual care resuscitation guided by paramedic medical directives. The primary outcome is mortality prior to hospital discharge or within 90 days of admission. Secondary outcomes are all-cause mortality at 90 days after enrolment.
Safety outcomes include the proportion of patients with pulmonary oedema during transport to hospital and on initial chest X-ray and the proportion of patients with anaphylaxis or suspected allergic reactions to study medication.