Highlights
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We looked at the management of septic shock by remote retrieval medical teams.
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Treatment was initiated early, and patients were managed aggressively in the retrieval setting.
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We observed a lower mortality rate (13.4%) for this cohort than the national average (32.4%).
Abstract
This study aims to assess the management of septic shock by air medical retrieval
teams in the remote setting. A retrospective observational study was performed over
36 months. Sixty-seven adult patients who met the criteria for septic shock were included.
Respiratory sepsis was the working diagnosis for 53% of patients; this was confirmed
on intensive care unit (ICU) discharge in 39% of patients. Intravenous antibiotics
and oxygen were delivered in over 90% of patients. Central and arterial line insertions
were performed in 48% and 40% of patients, respectively, and 79% of patients were
catheterized. Thirty-three percent of patients required intubation, and 80% of patients
received an initial crystalloid fluid bolus of 20 mL/kg. Vasopressors were started
in 89% of patients. Upon reaching definitive care, 91% of patients were admitted to
a high-dependency or ICU setting, with a median length of ICU stay of 4 days and a
30-day mortality of 13%. Of those admitted to the ICU, intubation was required in
48%, new renal support in 20%, and blood pressure support in 84% of patients, respectively.
Septic shock was recognized early and managed aggressively by remote retrieval teams,
which may have contributed to the low mortality rate observed.
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Article Info
Publication History
Published online: May 24, 2016
Identification
Copyright
Crown Copyright © 2016 Published by Elsevier Inc. on behalf of Air Medical Journal Associates. All rights reserved.
