Are we overlooking the rural patient journey when it comes to sepsis diagnosis and management?

Surviving Sepsis Campaign guidelines have progressively moved towards faster time-based treatment targets over recent years despite international data consistently showing low protocol adherence. A key stakeholder in Australian healthcare remains overlooked in sepsis research: the under-resourced rural ED. The journey of the rural patient markedly differs to that of the metropolitan patient, involving greater reliance upon patient transfers, reduced staffing and resource inaccessibility, directly impacting on sepsis protocol adherence and patient outcomes. Greater representation of rural patients and EDs in Australian sepsis research is paramount in guiding future sepsis treatment protocols. This perspective piece explores current international sepsis literature, recognising significant barriers to sepsis protocol adherence specific to rural Australian EDs.