The Role of Perceived Urgency and Barriers in Using Emergency Medical Care for Sepsis: A German-Wide, Representative...

Delays in emergency medical care (EMC) can increase sepsis mortality. Sepsis symptoms, however, are less known in the public compared with signs of stroke and myocardial infarction. Using case vignettes, we investigated the decision to seek EMC in sepsis-related compared with other emergencies.

Cross-sectional survey.

A representative nationwide survey was conducted in December 2023 among 1013 persons in Germany.

None.

A standardized questionnaire was administered via face-to-face interviews to assess perceived urgency, the tendency to seek EMC, sepsis knowledge, and barriers to EMC utilization. Multiple regression analyses were conducted to identify predictors for the perceived urgency and the tendency to seek EMC. Across ten case vignettes, the perceived urgency was lower for sepsis-related (mean = 3.93, sd = 0.64) than for nonsepsis-related emergencies (mean=4.15, sd = 0.67). In sepsis-related vignettes, the immediate EMC option ("Call emergency medical services or go to the emergency department [ED] immediately") was chosen by 18.3-43.2% of respondents, compared with 20.1-71.9% in nonsepsis-related vignettes. Even when situations were rated as very urgent, EMC use was less likely for sepsis-related emergencies (35%) than for nonsepsis-related emergencies (17%). In regression analyses, sepsis knowledge was the only predictor of perceived urgency, and perceived urgency was the strongest predictor of EMC use. The likelihood of EMC use in sepsis-related emergencies was 14.9 percentage points lower ( p < 0.01) than in nonsepsis-related emergencies; "long waiting times in the ED" was the only significant barrier for EMC use.

Compared with nonsepsis emergencies, sepsis-related emergencies are perceived as less urgent and less often lead to EMC use, even if the level of perceived urgency is the same. As the perceived urgency is associated with sepsis knowledge, this underlines the need to increase efforts to improve sepsis knowledge and the awareness that sepsis requires timely emergency care in the general public.