Investigate the relationship between lactate levels and mortality rate in sepsis, the feasibility of its use in the pre-hospital environment, how it can guide pre-hospital treatment of sepsis (including different treatment regimens), and the value early, aggressive treatment may have on improving patient outcome and mortality.

Lactic acidosis is known to be correlated with high mortality; a blood lactate level above 4mmol has been found to be associated with a 27% mortality rate, and is an accurate predictor of morbidity and mortality especially in the absence of clinical signs of shock.

Briefly investigate the relationship between lactate levels and mortality rate in sepsis, the feasibility of its use in the pre-hospital environment, how it can guide pre-hospital treatment of sepsis (including different treatment regimens), and the value early, aggressive treatment may have on improving patient outcome and mortality.

Literature reviews will be conducted from journals sourced from databases including ProQuest Medical Library, Medline, PubMed and ScienceDirect. Background information may be sourced from textbooks such as Oh’s Intensive Care Manual, as well as recent peer-reviewed journal articles.

Potential problems encountered may be relevance of research to pre-hospital and paramedic practice, and obtaining research with high levels of evidence relevant to pre-hospital practice. The bulk of research concentrates on in-hospital investigations and subsequent treatment; this is often unavailable in the pre-hospital environment (e.g. pre-hospital lactate analysis is likely to be performed in isolation, as opposed to full blood analysis in-hospital). Furthermore, it is important to ensure literature sourced regarding pre-hospital management is comparable to, and can be applied to, Australian ambulance services…………………………….

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