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    Point-of-care lactate measurement for suspected sepsis in the prehospital environment: are we missing the point at the sharp end?

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    Publication date
    2020-04-02
    Author
    Lightowler, Bryan
    Keyword
    Handheld
    Lactate
    Point-of-care
    Prehospital care
    Sepsis
    Peer-Reviewed
    Yes
    
    Metadata
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    Abstract
    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.
    URI
    http://hdl.handle.net/10454/18283
    Version
    No full-text in the repository
    Citation
    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 publisher’s version
    https://doi.org/10.12968/bjhc.2019.0071
    Type
    Article
    Collections
    Health Studies Publications

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