Two out of the four internationally-recommended screening tools used by emergency medical services are inadequate for recognizing sepsis, according to new research presented at the European Emergency Medicine Congress.
Two out of the four internationally-recommended screening tools used by emergency medical services are inadequate for recognizing sepsis, according to new research presented at theMrs.
Mrs. Piedmont and colleagues say the Surviving Sepsis Campaign guidelines about which sepsis screening tool is the most reliable for use by EMS are not specific enough and are based on little, useful evidence. The aim of the current study was to assess which of four screening tools was best for EMS to predict sepsis—NEWS-2, MEWS , SIRS or qSOFA.
When they compared the performance of the four screening tools, the researchers found that NEWS-2 was the best for identifying patients with sepsis as it had a sensitivity of 72.2%, followed by MEWS, which had a sensitivity of 46.8% and a specificity of 88.4%, SIRS , and qSOFA . "No screening tool provides ideal performance. NEWS-2 best supports emergency medical services in identifying most patients with sepsis. EMS patients that are NEWS-2 positive should be flagged up as potentially having sepsis and referred for special attention and assessment by emergency doctors who are expert in sepsis. If EMS insist on using the qSOFA, they should be aware that a positive qSOFA makes sepsis likely, but also, that a negative qSOFA cannot rule out sepsis conclusively.
There were two things that could be improved, say the researchers: better and complete assessments of vital signs, such as body temperature and breathing rate; and"translating" alarming vital signs into a suspicion of sepsis, which could be helped by using a good sepsis screening tool.
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