A comparison of Australasian jurisdictional ambulance services’ paramedic clinical practice guidelines series: Adult sepsis
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Keywords

Australasia
Emergency Medical Technician
Guideline
Paramedic
Scope of Practice
Sepsis

How to Cite

1.
Wilkinson-Stokes M, Ryan E, Williams M, Spencer M, Maria S, Colbeck M. A comparison of Australasian jurisdictional ambulance services’ paramedic clinical practice guidelines series: Adult sepsis. Australasian Journal of Paramedicine [Internet]. 2021Oct.10 [cited 2021Oct.19];18. Available from: https://ajp.paramedics.org/index.php/ajp/article/view/932

Abstract

Introduction
This article forms part of a series that seeks to identify interjurisdictional differences in the scope of paramedic practice and differences in patient treatment based upon which jurisdiction a patient is geographically located within at the time of their complaint.

Methods
The current CPGs of each JAS were accessed during June 2020, and updated in August 2021. Content was extracted and verified.

Results
Nine services provide antibiotics for meningococcal septicaemia, with dosage ranging from 1 – 4 grams. Five services provide antibiotics for non-meningococcal sepsis (three under doctor approval), with choice of antibiotic including Ceftriaxone, Benzylpenicillin, Amoxicillin, and Gentamicin. Three services provide antipyretics, one provides corticosteroids under doctor approval, and all provide fluids (with dosage ranging from 20 – 60 ml/kg). ICPs are allowed to provide adrenaline infusions in nine services, noradrenaline in three services (one requiring doctor approval), and metaraminol in three services. Two additional services restrict metaraminol to specialist paramedics, with one of these requiring doctor approval. Two services perform phlebotomy and one takes lactate. Paramedics perform unassisted intubation in one service, with nine restricting this to ICPs. Facilitated or Ketamine-only intubation is performed by ICPs in one service. Rapid or delayed sequence induction is performed by ICPs in six services, and restricted to specialists in two services.

Conclusion
The domestic jurisdictional ambulance services in Australasia have each created unique treatment clinical practice guidelines that are heterogeneous in their treatments and scopes of practice. A review of the evidence underlying each intervention is appropriate to determining best practice.

https://doi.org/10.33151/ajp.18.932
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References

Wilkinson-Stokes M, Maria S, Colbeck M. A comparison of Australasian jurisdictional ambulance services’ clinical practice guidelines series: an introduction. Australasian Journal of Paramedicine 2021;18. doi.org/10.33151/ajp.18.914