Antibiotics will not to be given for sepsis, trust says
Paramedics treating sepsis patients still may not administer antibiotics, despite concerns raised by a coroner.
Samantha Brousas, 49, from Gresford, died in 2018 after waiting for three hours outside hospital in a Welsh Ambulance Service Trust (WAST) vehicle. Following the inquest, coroner Joanne Lees wrote to the trust highlighting that sepsis patients' mortality risks rose in the absence of antibiotics. But WAST says it has no plans to allow paramedics to administer antibiotics. The inquest into the death of Ms Brousas heard that WAST paramedics suspected she had sepsis. Although she was kept waiting in the ambulance outside Wrexham Maelor Hospital, they were not allowed to administer antibiotics. In her report to WAST, Mrs Lees highlighted the "importance of the role of the paramedic in the early diagnosis of sepsis". She added the "absence of the administration of antibiotics increases the mortality risk of such patients". Evidence base In his response, WAST's executive medical director Dr Brendan Lloyd said there had been various studies on the feasibility of paramedics delivering antibiotics to "red flag" sepsis patients, including one by the East Midlands Ambulance Service and another in Holland. "The current evidence base is not strong enough to demonstrate the benefits of out-of-hospital administration of antibiotics in sepsis by all paramedics, including time taken to train, the costs involved to purchase the additional medications and equipment, and maintain competency in the use of the drugs," he said. "In addition, controlled use of antibiotics is considered best practice to prevent antimicrobial resistance, which is on the increase." Dr Lloyd said the Trust favoured antibiotics being given within emergency departments instead of in an ambulance. "For patients, held in the back of ambulances due to excessive delays, who require antibiotic treatment, this can be initiated by Health Board Emergency Department staff who are qualified to prescribe the medication," he said.