Point-of-care lactate measurement for suspected sepsis in the prehospital environment: are we missing the point at the sharp end?
Publication date
2020-04-02Author
Lightowler, BryanPeer-Reviewed
YesOpen Access status
closedAccessAccepted for publication
2020-01-13
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Show full item recordAbstract
Expecting ambulance clinicians to dependably differentiate the life-threatening organ dysfunction caused by sepsis from an inflammatory response to a non-infectious aetiology, relying upon vital signs and a physical examination of the patient alone, must be considered unrealistic. Although lactate measurement has been integrated into numerous prehospital sepsis screening tools, it is not yet measured routinely within UK ambulance services. Research has generally focused on whether handheld point-of-care lactate measurement devices are as accurate as laboratory analysis of venous or arterial samples. The weight of literature has concluded negatively in relation to this. However, there is potential for handheld devices to be used independently to monitor trends in lactate elimination or accumulation to inform decisions on the efficacy of prehospital interventions, or simply to report categorical data in terms of whether lactate levels are elevated or not. This offers UK paramedics the opportunity to improve sepsis care through the enhanced assessment of risk and acuity, the identification of patients with cryptic shock, more aggressive fluid resuscitation and advanced notification to receiving units.Version
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Lightowler B (2020) Point-of-care lactate measurement for suspected sepsis in the prehospital environment: are we missing the point at the sharp end?. British Journal of Health Care Management. 26(4): 1-9.Link to Version of Record
https://doi.org/10.12968/bjhc.2019.0071Type
Articleae974a485f413a2113503eed53cd6c53
https://doi.org/10.12968/bjhc.2019.0071