A Survey of the Competency of Ambulance Service Personnel in the Diagnosis and Management of Sepsis

BackgroundFew studies have evaluated the current status of knowledge of sepsis in ambulance service personnel.ObjectiveOur aim was to ascertain the levels of competency and proficiency of ambulance service personnel in the diagnosis and management of severe sepsis.MethodsA questionnaire was submitted to a sample of 208 participants in a professional ambulance service conference, and was recovered on site. The study probed eight areas of sepsis diagnosis and management based on modifications of a questionnaire used in a previous study.ResultsThe term sepsis in Japanese, Haiketsushou, was familiar to 99% of Japanese certified emergency life-saving technicians (ELST) (Group I) and to 92% of noncertified ambulance service personnel (Group II), although 15% of participants in Group I and 44% in Group II ignored the meaning of sepsis. The definition of sepsis as “body's response to infection,” “blood poisoning,” or “shock due to bacteria in blood” were selected by 17%, 16%, and 37%, respectively, in Group I, and 4%, 6%, and 22%, respectively, in Group II. The mortality associated with sepsis was underestimated by 57% in Group I and 78% in Group II. Vital signs raising a suspicion for sepsis and their pertinent ranges were correctly chosen by only 50% of certified ELST. Hypothermia was prominently undervalued as a sign raising the suspicion of sepsis.ConclusionsInsufficient knowledge and perception for sepsis in Japanese ambulance services is revealed. A higher level of onsite or formal postgraduate education needs to be provided with a view to improve the prehospital management of sepsis.