Observational studyCritical care (London, England)2014
Prehospital intravenous access and fluid resuscitation in severe sepsis: an observational cohort study.
Observational study in Critical care (London, England), 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 44 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
44 citing papers in PubMed, 1 synthesis or guideline pooled it, 97 citations in OpenAlex.
- Impact of Prehospital Care on Outcomes in Sepsis: A Systematic Review.The western journal of emergency medicine · 2016Pooled it
- When to choose intraosseous access in prehospital trauma care: A registry-based study from the Israel Defense Forces.Chinese journal of traumatology = Zhonghua chuang shang za zhi · 2025Article
- Health-Related Quality of Life Among Patients Who Have Survived an Episode of Sepsis in the United States: A Systematic Review.Infectious diseases and therapy · 2025Review
- Sepsis management in pre-hospital care - the earlier, the better?BMC emergency medicine · 2024Article
- The performance of screening tools and use of blood analyses in prehospital identification of sepsis patients and patients suitable for non-conveyance - an observational study.BMC emergency medicine · 2024Observational
- LncRNA KCNQ10T1 shuttled by bone marrow mesenchymal stem cell-derived exosome inhibits sepsis via regulation of miR-154-3p/RNF19A axis.Cell and tissue research · 2023Article
- The Prevalence and Utilization of Prehospital IV Access in Critically Ill Patients in the Emergency Department.Cureus · 2023Article
- Prehospital fluid therapy in patients with suspected infection: a survey of ambulance personnel's practice.Scandinavian journal of trauma, resuscitation and emergency medicine · 2022Article
- Improving peripheral venous cannula insertion in children: a mixed methods study to develop the DIVA key.BMC health services research · 2022Article
- Concept review of regionalized systems of acute care: Is regionalization the next frontier in sepsis care?Journal of the American College of Emergency Physicians open · 2022Article
- Effect of prehospital transportation on 24-h fluid volume, aFrontiers in medicine · 2022Article
- Assessment of patients with suspected sepsis in ambulance services: a qualitative interview study.BMC emergency medicine · 2021Article
- The Surviving Sepsis Campaign: Fluid Resuscitation and Vasopressor Therapy Research Priorities in Adult Patients.Critical care medicine · 2021Article
- Mode of Arrival to the Emergency Department and Outcomes in Nontraumatic Critically Ill Adults.Critical care explorations · 2021Article
- The surviving sepsis campaign: fluid resuscitation and vasopressor therapy research priorities in adult patients.Intensive care medicine experimental · 2021Review
- Silencing CDK6-AS1 inhibits LPS-induced inflammatory damage in HK-2 cells.Open medicine (Warsaw, Poland) · 2021Article
- Does Being Transported by Emergency Medical Services Improve Compliance with the Surviving Sepsis Bundle and Mortality Rate? A Retrospective Cohort Study.Journal of epidemiology and global health · 2020Article
- Clinical characteristics and course of out-of-hospital shock in a national emergency medical services cohort.Journal of the American College of Emergency Physicians open · 2020Article
- Epidemiology and patient predictors of infection and sepsis in the prehospital setting.Intensive care medicine · 2020Article
- Association between Blood Pressure after Haemodynamic Resuscitation in the Prehospital Setting and 28-Day Mortality in Septic Shock.Turkish journal of anaesthesiology and reanimation · 2020Article
Corrections and comments
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Authors and funding
9 authors at 5 institutions in 1 country.
Funding
Abstract
introductionPrompt treatment of severe sepsis in the Emergency Department reduces deaths, but the role of prehospital fluid resuscitation is unknown. We sought to determine the risk-adjusted association between prehospital fluid administration and hospital mortality among emergency medical services (EMS) patients admitted with severe sepsis.
methodsWe performed a prospective, observational study of patients hospitalized with severe sepsis on admission among 45,394 adult EMS encounters taken to 15 hospitals from 11/2009 to 12/2010 by a two-tier EMS system in King County, Washington. The region mandated recording of prehospital intravenous catheter and fluid administration in prehospital records, along with detailed demographic, incident, physiologic, and hospital adjustment variables. We determined the effect of prehospital intravenous catheter or fluid versus no catheter or fluid on all-cause mortality using multivariable logistic regression.
resultsOf all encounters, 1,350 met criteria for severe sepsis on admission, of whom 205 (15%) died by hospital discharge, 312 (23%) received prehospital intravenous fluid, 90 (7%) received a prehospital catheter alone and 948 (70%) did not receive catheter or fluid. EMS administered a median prehospital fluid volume of 500 mL (interquartile range (IQR): 200, 1000 mL). In adjusted models, the administration of any prehospital fluid was associated with reduced hospital mortality (Odds ratio =0.46; 95% Confidence interval: 0.23, 0.88; P =0.02) compared to no prehospital fluid. The odds of hospital mortality were also lower among severe sepsis patients treated with prehospital intravenous catheter alone (Odds ratio =0.3; 95% Confidence interval: 0.17 to 0.57; P <0.01).
conclusionsIn a population-based study, the administration of prehospital fluid and placement of intravenous access were associated with decreased odds of hospital mortality compared with no prehospital catheter or fluid.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.