Abstract

Background
Paediatric sepsis remains a leading cause of preventable morbidity and mortality, contributing to 11 million deaths annually, including 1.2 million children [1, 2]. Early recognition is critical, yet prehospital identification is hindered by subtle presentations, age-related physiological variability, and limited diagnostic capability [1, 3]. Currently, no validated prehospital paediatric sepsis screening tool exists. The aim of this project was to develop and implement an evidence-based prehospital paediatric sepsis screening tool for paramedics.

Methods
The development process included a targeted literature review and formal stakeholder engagement with Hamad Medical Corporation Ambulance Service (HMCAS) and Sidra Medicine. The iterative tool refinement was informed by international guidelines, aligned with Sidra Medicine pathways, and adapted to support HMCAS clinical practice guidelines. Age-specific physiological thresholds were calibrated using Advanced Paediatrc Life Support vital-sign parameters within the sepsis context. Implementation was supported by a blended educational model comprising 4 hours of online preparatory modules, 7 hours of face-to-face workshops, and simulation-enhanced active learning sessions.

Results
The final screening tool integrated infection-risk assessment, high-risk clinical criteria, age-specific vital-sign thresholds, and key physiological indicators, supported by an algorithm (Figure 1). A corresponding prehospital sepsis care bundle (Figure 2) was incorporated to standardise timely recognition, intervention, and escalation, aligned with the “Sepsis Golden Hour” and “Sepsis 6” principles [1, 3]. Clinical validation and alignment were provided through expert review by paediatric sepsis specialists from Sidra Medicine. Case-based learning, deliberate practice, and simulations supported the application of the tool for operational practice.

Conclusion
The Prehospital Paediatric Sepsis Screening Tool was successfully developed and implemented, supported by structured educational preparation to strengthen early recognition and clinical decision-making. By the end of Quarter 1, 2025, 1,513 HMCAS staff (89%) had completed the training. Future study with ongoing evaluation should examine the tool’s impact on recognition accuracy, timeliness of intervention, and patient outcomes across the prehospital paediatric sepsis pathway.

Author contributions
All authors contributed equally and validated the final version of record.
Declarations
Conflicts Of Interests
The Authors declare that there is no conflict of interest.
Funding
No financial support or sponsorship was received for the development or implementation of the Prehospital Paediatric Sepsis  Screening Tool.
Registration
No registration applicable.
Data availability statement
The data that support the findings of this study are available from the corresponding author upon reasonable request.
Ethical approval
Ethical approval for this study was not required.

References

1.      World Sepsis Day [Internet]. [cited 2025 Nov 18]. Sepsis facts. Available from: https://www.worldsepsisday.org/sepsisfacts

2.      Zick, Marvin. Global Sepsis Alliance Joins WHO’s Acute Care Action Network (ACAN) [Internet]. Global Sepsis Alliance; 2024 [cited 2024 Dec 12]. Available from: https://globalsepsisalliance.org/news/2024/10/21/global-sepsis-alliance-joins-whos-acute-care-action-network-acan

3.      Labib A, Ashour R. Qatar National Paediatric Sepsis Program: Where are we? Qatar Med J. 2019 Nov 7;2019(2):65. https://doi.org/10.5339/qmj.2019.qccc.65