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EMSWORLD.com | AUGUST 2017 19 sis alert patients, the emergency department continued sepsis care. Finally, there were no adverse effects, such as fluid overload or allergic reaction, reported by the receiving facilities' sepsis coordinator. This was a very well-conducted study that provides some evidence that paramedics can successfully assess and manage a sep- sis patient in the prehospital environment. All studies have limitations, and this one is no different. Limitations include perform- ing a study in a single EMS system, missing data, and limitations in the statistical anal- yses made possible by the data collection method. The authors were also not able to evaluate patient outcomes. For regular readers of this column: First, thanks for reading! However, you may notice that this is the first study we've reviewed that did not include any p-values. This was a descriptive study and no statistical tests were performed. Though this was not a sta- tistically rigorous paper, it significantly added to the literature on prehospital sepsis care. Paramedic-led Research Some questions were not answered in this manuscript. As discussed, a lot of prepara- tory work was needed to add medications to the state formulary, develop a prehospital sepsis protocol, and train 120 paramedics. However, the authors described this study as a retrospective case series. In other words, they completed all preliminary work but then looked back at the data and ana- lyzed them after these data were collected. This could have just been an oversight in which the EMS agency in conjunction with their local hospitals were so motivated to begin caring for sepsis patients that they forgot to develop a prospective data collec- tion plan. Yet the authors stated that they evaluated each step of the CMS sepsis core measure bundle prior to implementing the next step. Clearly, there was some thought put into a prospective analysis. It just does not appear to have been enough to support the analyses required to meet the stated study objective. This is unfortunate because a more sophisticated data collection plan that included patient outcome data could have really helped us understand the true impact of implementing the CMS bundle. One of the most encouraging things about this manuscript is that the first author is a paramedic. It is encouraging to see our field making important contributions to research. So for all those reading this who might be intimidated by the thought of getting involved in research, Mr. Walchok has shown that you don't have to be an epidemiologist or even a physician to make a substantial contribution. Great work can be performed without sophisticated statistical tests and reporting p-values. I hope to see more EMS research led by EMTs and paramedics. ABOUT THE AUTHOR Antonio R. Fernandez, PhD, NRP, FAHA, is research director at the EMS Performance Improvement Center and an assistant professor in the Department of Emergency Medicine at the University of North Carolina–Chapel Hill. He has been a nationally certified paramedic since 2005 and completed the EMS Research Fellowship at the National Registry of Emergency Medical Technicians. ColumbiaSouthern.edu | 877.347.6050 Accredited Online EMSA Degrees | Wesley Murphy CSU Student Columbia Southern University offers completely online degrees for EMS professionals interested in taking the next step in their career. CSU's coursework covers relevant topics within the emergency medical services industry including community relations, EMS communications, risk management, public safety and more. Learn more about our online EMSA degrees at ColumbiaSouthern.edu/EMSA. For More Information Circle 19 on Reader Service Card