Research Nurse, Department of Nursing and Midwifery, University of the Highlands and Islands.
Br J Community Nurs. 2021 Mar 2;26(3):122-129. doi: 10.12968/bjcn.2021.26.3.122.
Sepsis is a life-threatening complication from infection. The early detection of sepsis pre-hospital is challenging. Early warning scores (EWS) are used in hospitals to identify deteriorating patients. The pre-hospital setting could be a beneficial extension to the use of EWSs. This review aimed to determine whether EWSs can identify patients with sepsis pre-hospital and predict patient outcomes. Bibliographic databases were searched for studies evaluating the pre-hospital use of EWSs. Studies were screened using eligibility criteria. Two studies examined the ability of pre-hospital EWSs to identify patients with critical illness, showing high sensitivity but low specificity. Four studies determined the prognostic effects of the National Early Warning Score (NEWS). The patients identified by NEWS to be high-risk were associated with worse outcomes. This systematic review demonstrated the successful use of EWSs in the pre-hospital setting, in identifying patients most at risk of deterioration and as a useful tool for decision-making.
败血症是一种由感染引起的危及生命的并发症。败血症在院前的早期检测具有挑战性。预警评分（EWS）用于医院识别病情恶化的患者。院前环境可以是 EWS 应用的有益扩展。本综述旨在确定 EWS 是否可以在院前识别败血症患者并预测患者预后。检索了评估院前 EWS 使用的研究的文献数据库。使用纳入标准筛选研究。两项研究检查了院前 EWS 识别危重病患者的能力，显示出高敏感性但特异性低。四项研究确定了国家早期预警评分（NEWS）的预后影响。NEWS 确定为高危的患者与更差的结局相关。本系统评价表明 EWS 在院前环境中的成功应用，可识别最有可能恶化的患者，并作为决策的有用工具。
