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The Israel Association for Emergency Medicine

Blood culture collection and administration of intravenous ceftriaxone by paramedics in patients with suspected sepsis (the pass trial)

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Daniel Cudini BEx Sci, BEmergHlth (Paramedic), Grad Dip EmergHlth (ICP), MACParaKaren Smith BSc(Hons), Grad Cert Exec BA, Grad Dip Epi and Biostats, PhD, OAM

Abstract           

Objective

To evaluate the feasibility of pre-hospital blood culture (BC) collection and intravenous (IV) antibiotic administration in patients with suspected sepsis.

Methods

In this open-label trial, BCs were collected in all participants, who were then randomised to ongoing care (control) or ongoing care plus 2 g IV ceftriaxone (intervention). Time to antibiotic administration was the primary outcome.

Results

Thirty-five patients were enrolled and randomised (21 control, 14 intervention). BCs were obtained in 89% (n = 31/35) and grew a pathogen in 42% (n = 13/31). Intervention patients received antibiotics a median of 108 (95% CI 34 to 170) minutes earlier (P < 0.01).

Conclusion

BCs were successfully obtained by paramedics, and pre-hospital IV ceftriaxone resulted in expedited antibiotic administration.

Clinical Trial Registration: ACTRN12618000199213.

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