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The Pre-hospital Sepsis Score (PSS): An Evidence-Based Early Identification Tool

Amado Alejandro Baez

The care of the critically sick and injured often begins in the Pre-hospital setting; recent studies demonstrate that early diagnosis, within the first three hours of presentation combined with aggressive fluid resuscitation, early antibiotics administration and lactate measurements can improve the outcomes of patients with severe sepsis.
The Pre-hospital Sepsis Project (PSP) is a multifaceted study that aims to improve the out-of-hospital care of patients with sepsis by means of knowledge translation and enhancement of skills. Since 2005, our PSP study group has been researching sepsis in the out-of-hospital environment. In a recent publication our PSP group found that out-of-hospital shock index and respiratory rate are highly predictive of ICU admissions for patients presenting sepsis. The Pre-hospital Sepsis Score (PSS) was developed using this data, with maximum points total of 4 points, incorporating respiratory rate, fever and shock index. The patient population can be stratified based on the PSP-S: 1 point is low risk, 2 points is moderate risk, and 3-4 point is high risk.