[FireBeyond]

You're right, and I should be more specific - what I referred to was things like SIRS, SOFA, and qSOFA (which was being introduced at the BLS level around here in 2022) for "suspicion scores".

But even then:

> but it seems to me that few clinicians would have had a strong suspicion of it in this case...

Tachycardic, febrile and with a suspected infection?

The issue here seemed to me to be two-fold, misdiagnosis of a viral infection versus bacterial, but in the setting of treating for a bacterial infection to then be consciously overlooking multiple markers for sepsis?

[orthozato]

I 100% get where you are coming from; however, in the ER setting, multiple non life threatening conditions could cause these symptoms (I assume paramedics don't get as much experience in in-hospital settings, please correct me if I am wrong as I am not from the US!)

That said, there was a cascade of errors that ultimately led to this very very unfortunate outcome (that maybe could have been prevented, or maybe not)

Had the chest x-ray been ordered perhaps his enlarged heart could have been noticed in due time.

I do not mean to be pretentious in any way. I hope my english does not interfere with this.

[FireBeyond]

You're absolutely fine! Definitely a lot other things can also have those influences on temperature, HR. Our EMS system started teaching SIRS (and then qSOFA) to EMS providers to have them tell the charge nurse that the patient "meets Sepsis criteria", because this was being missed in triage and septic patients were spending hours on hours waiting for care.

Paramedics don't get very much in-hospital time here, other than getting intubation experience in the OR with an anesthesiologist.

I appreciate your input, it does not come across at all pretentious - and as a paramedic, I would never want to "not learn more medicine".