Understanding of sepsis among emergency medical services: a survey study.

BACKGROUND: Emergency medical services (EMS) personnel commonly encounter sepsis, yet little is known about their understanding of sepsis. STUDY OBJECTIVES: To determine the awareness, knowledge, current practice, and attitudes about sepsis among EMS personnel. METHODS: We performed an anonymous, multi-agency, online survey of emergency medical technicians (EMTs), firefighter-emergency medical technicians (FF-EMTs), and paramedics in a metropolitan, 2-tier EMS system. We compared responses according to the level of EMS training and used multivariable logistic regression to determine the odds of correctly identifying the definition of sepsis, independent of demographic and professional factors. RESULTS: Overall response rate of study participants was 57% (786/1390), and was greatest among EMTs (79%; 276/350). A total of 761 respondents (97%) had heard of the term "sepsis." EMTs and FF-EMTs were at significantly reduced odds of correctly defining sepsis compared to paramedics, independent of age, sex, and years of experience (EMTs: odds ratio 0.44, 95% confidence interval 0.3-0.8; FF-EMTs: odds ratio 0.32, 95% confidence interval 0.2-0.6. Overall, knowledge of the clinical signs and symptoms and recommended treatments for sepsis was typically>75%, though better among paramedics than EMTs or FF-EMTs (p<0.01). The majority of respondents believed sepsis is not recognized by EMS "some" or "a lot" of the time (76%, 596/786). CONCLUSIONS: EMS personnel demonstrated an overall sound awareness of sepsis. Knowledge of sepsis was less among FF-EMTs and EMTs compared to paramedics. These results suggest that paramedics could be integrated into strategies of early identification and treatment of sepsis, and EMTs may benefit from focused education and training.