Tirado William C
Author Affiliations: Keigwin School of Nursing, Jacksonville University, Jacksonville, Florida, USA (Mr Tirado); and Critical Care Department, HCA Florida Orange Park Hospital, Medical Center in Bellair-Meadowbrook Terrace, Orange Park, Florida, USA (Mr Tirado).
Adv Emerg Nurs J. 2025;47(2):152-167. doi: 10.1097/TME.0000000000000561. Epub 2025 Apr 1.
Sepsis remains a global health challenge, with millions affected and high mortality rates. Early recognition is critical for improving outcomes, particularly in prehospital settings where timely interventions can significantly impact patient survival. This literature review examines screening tools used in prehospital environments, focusing on their predictive abilities, ease of use, and limitations in detecting sepsis. Tools such as the quick Sequential Organ Failure Assessment (qSOFA), National Early Warning Score (NEWS), National Early Warning Score 2 (NEWS2), Systemic Inflammatory Response Syndrome, and Monocyte Distribution Width offer varied strengths and applications in identifying sepsis. Research shows that NEWS and NEWS2 demonstrate higher sensitivity for predicting mortality, while qSOFA offers simplicity but may lack sensitivity outside of acute care settings. Differential diagnoses, such as pulmonary embolism and adrenal crisis, can mimic sepsis, making accurate assessment essential. The review highlights the role of Emergency Medical Services (EMS) and Family Nurse Practitioners in early detection and emphasizes the importance of evidence-based practices and clear protocols. This review aims to provide EMS and Nurse Practitioners with the knowledge and tools to recognize sepsis early, ensuring appropriate referrals and improving patient outcomes.
脓毒症仍然是一项全球性的健康挑战，数百万人受到影响，死亡率很高。早期识别对于改善预后至关重要，尤其是在院前环境中，及时干预可显著影响患者生存。这篇文献综述考察了院前环境中使用的筛查工具，重点关注其预测能力、易用性以及在检测脓毒症方面的局限性。快速序贯器官衰竭评估（qSOFA）、国家早期预警评分（NEWS）、国家早期预警评分2（NEWS2）、全身炎症反应综合征和单核细胞分布宽度等工具在识别脓毒症方面具有不同的优势和应用。研究表明，NEWS和NEWS2在预测死亡率方面表现出更高的敏感性，而qSOFA虽然简单，但在急性护理环境之外可能缺乏敏感性。肺栓塞和肾上腺危象等鉴别诊断可能会模仿脓毒症，因此准确评估至关重要。该综述强调了紧急医疗服务（EMS）和家庭护士从业者在早期检测中的作用，并强调了循证实践和明确方案的重要性。本综述旨在为紧急医疗服务人员和护士从业者提供早期识别脓毒症的知识和工具，确保适当转诊并改善患者预后。
