Field Paramedic Application of Sepsis Triage
Field Paramedic Application of Sepsis Triage
Given the implementation of the Hamilton Early Warning Score (HEWS) and the use of
 capnography by paramedics, this study will involve a large multi-site retrospective
 evaluation (before vs after implementation) of the HEWS score and comparison of the HEWS to
 systemic inflammatory response syndrome (SIRS), quick Sepsis Related Organ failure Assessment
 (qSOFA) and Modified Early Warning Score (MEWS) when applied retrospectively for the
 identification of sepsis in the prehospital setting.
1. To determine the accuracy of the HEWS score, compared to qSOFA, and SIRS for early
 sepsis recognition when used in the prehospital setting by paramedics for the
 identification of patients with sepsis or suspected sepsis.

 2. To evaluate the addition of ETCO2 values to predict mortality in patients who screen
 positive for sepsis.

 3. To identify the before and after healthcare outcomes of a prehospital sepsis alert
 program.
Inclusion Criteria:

 Any patient to which paramedics apply the Hamilton Early Warning Score or patients who
 arrive to the Emergency Department (ED) by ambulance without a pre-alert and meet the
 definition of sepsis in the ED will also be included, and patient is ≥ 18 years

 Exclusion Criteria:

 Patient is an inter-facility transfer, or patients with absent vital signs are absent, or
 death before blood can be drawn in the Emergency Department, or the patient fits the
 criteria for another prehospital alert (ST-elevation myocardial infarction, cerebrovascular
 vascular accident, or trauma)