Table 1

Characteristics of included studies

StudyPurposeDesignStudy countryNumber of centresSample sizeReported incidenceGRADE
Studies describing the identification of sepsis by EMS providers
Asayama and Aikawa13To evaluate SIRS criteria as a predictor of mortalityRetrospective cohortJapan1 Hospital59 Patients59/2180; 2.7%Low
Bayer et al18To develop and evaluate an early sepsis detection tool for EMSRetrospective cohortGermany1 Hospital375 Patients375/14 399; 2.6%Moderate
Groenewoudt et al19To describe patients transported by EMS and their management by EMS providersRetrospective cohortNetherlands1 Hospital287 PatientsNot availableModerate
Guerra et al14To evaluate EMS provider identification of severe sepsis using a screening toolProspective cohortUSA3 Hospitals112 Patients112/15 538; 0.7%Low
Polito et al17To develop an EMS screening tool for identifying severe sepsisRetrospective cohortUSA1 Hospital555 Patients75/555; 14%*Low
Seymour et al8To describe the incidence of severe sepsis seen in the prehospital settingRetrospective cohortUSANot described13 249 Patients13 249/540 351; 2.5%Moderate
Studnek et al12To determine the effect of prehospital treatment on the time to definitive sepsis treatmentProspective cohortUSA1 Hospital311 PatientsNot availableLow
Suffoletto et al15To evaluate EMS provider impression and physiological measures on the identification of patients with severe infectionProspective cohortUSA1 Hospital201 EMS providers16/199; 8%Very low
Wallgren et al16To validate prehospital screening tools for sepsis against provider impressionRetrospective cohortSweden1 Hospital353 PatientsNot availableVery low
Studies describing EMS care delivery of patients with sepsis
Baez et al23To assess the predictive effect of prehospital physiological measures on patient outcomeRetrospective cohortUSA1 Hospital63 PatientsNot availableVery low
Band et al24To assess time to treatment for patients arriving with EMSProspective cohortUSA1 Hospital963 PatientsNot availableModerate
Femling et al25To describe patients transported by EMS and their subsequent ED management and outcomesRetrospective cohortUSA6 Hospitals485 PatientsNot availableLow
Seymour et al21 22To determine the impact of prehospital fluid resuscitation on time to achieve resuscitation goalsRetrospective cohortUSA1 Hospital52 PatientsNot availableLow
Seymour et al21 22To describe patient characteristics and EMS care of patientsRetrospective cohortUSA1 Hospital216 PatientsNot availableLow
Seymour et al20To describe the impact of EMS fluid resuscitation on patient mortalityProspective cohortUSA15 Hospitals1350 Patients1450/45 394; 3.2%Moderate
Wang et al11To describe patient characteristicsProspective cohortUSA1 Hospital1576 PatientsNot availableLow

  • *Total patient population restricted to exclude patients unlikely to have sepsis during EMS care (ex. Trauma, Cardiac arrest).

  • ED, emergency department; EMS, emergency medical services; GRADE, Grading of Recommendations Assessment, Development and Assessment; SIRS, systemic inflammatory response syndrome.