Paramedics Could Prevent Infection by Giving Antibiotics

A new study in the Journal of Orthopaedic Trauma has found that the first hour is critical in reducing infection rates after open fractures. The researchers, led by William Lack, M.D. of Loyola University Medical Center (LUMC), found that these rates can plummet if you give patients antibiotics within the first hour of injury.

Dr. Lack is an orthopaedic trauma surgeon at LUMC. The study was conducted at Carolinas Medical Center, where Dr. Lack completed a fellowship in orthopaedic trauma surgery.

Perhaps, goes the reasoning, paramedics administering antibiotics early on “may substantially improve outcomes for severe open fractures, ” said Dr. Lack and colleagues in their article. “This will require a collaborative effort between first responders and hospital providers.”

According to the February 25, 2015 news release, the study included 137 trauma patients who had open tibia fractures. The team found that patients who received antibiotics longer than 66 minutes after their injuries were 3.79 times more likely to experience infections. Patients whose wounds were not covered within the first five days were 7.39 times more likely to experience infections.

“Among patients who received antibiotics within one hour and wound closure within five days, only 2.8% had infections. Patients who had either delayed antibiotics or delayed wound closure had a 10.2% infection rate. Patients who had both delayed antibiotics and delayed wound closure suffered a 40.5% infection rate.”

Dr. Lack indicated that it would be feasible for paramedics to administer antibiotics in the field, noting that paramedics already have the right to administer other medications. And in the military, medics routinely administer antibiotics on the battlefield to soldiers with open fractures.

To ensure the safety and efficacy of allowing paramedics to administer antibiotics, Dr. Lack is participating in research at Carolinas Medical Center that will shed light on this topic.