Just One of Many Sad Stories

            Your patient has called 911 because they feel so badly they can’t even imagine going to the hospital on their own.  Diagnosed with a urinary tract infection five days ago and prescribed Ciprofloxacin, the patient returned home and began taking their medications.  Each time the patient would take the medication she would experience vomiting.  Now, four days later, the patient is exhausted, and tired of just getting increasingly sick as each hour passes.  She calls 911.

English: A paramedic preparing a intra-venous infusion for a patient (Photo credit: Wikipedia)

            The 911 system screens the call and once the patient indicates she is just sick and wants someone to take her to the hospital, the EMD system generates the call as an Alpha, non-emergency response because the patient is conscious and alert.  EMS is activated and checks en route. 

            The patient’s house is in a very rural, country setting and EMS arrives 19 minutes later. The patient presents as conscious, alert and oriented.  She is cool to the touch.  She says she doesn’t know why she is cool because she was burning up all night.  Her heart rate is about 133 beats per minute, and her BP is 90/60.  The patient is able to walk down the front steps of the residence to the ambulance after a 20 minute on-scene time.  The patient did receive a fluid bolus on the way to the hospital of normal saline due to the decrease in blood pressure.  After a non-emergency transport, she arrives at the emergency department 25 minutes later and patient care is transferred over and EMS personnel leaves.  The patient is dead seven hours later from decompensated septic shock. \

            Most EMS providers would have suspected flu, or possibly an intolerance to the antibiotics, or some type of virus on this patient and the call would have been handled in a routine manner just as the emergency department handled it, at the cost of the patient who has now passed away. 

            Benchmarks could have easily been used to determine the patient’s level of sickness within the first ten minutes of being on scene.  Why are so many patients with sepsis overlooked?  Why do so many people die aimlessly from sepsis each year?