Sharon FD Pioneers Prehospital Antibiotics Treatment in Massachusetts
The Sharon Fire Department (SFD), based in Norfolk County, Massachusetts, has a long history of providing effective prehospital care. In August 2025, the department took a significant step forward by adding prehospital antibiotics to its treatment suite.
“We are the pioneers in Norfolk County,” said Peterson Curalov, SFD firefighter, NREMT-paramedic, and EMS coordinator. “The SFD’s prehospital antibiotic program allows our paramedics to administer antibiotics to septic patients in the field, in compliance with Massachusetts’ Statewide Treatment Protocols, before they reach the hospital. Our paramedics are not only able to administer prehospital antibiotics, but they are also required to draw blood cultures using a sterile technique to prevent false readings. This is not an easy task in a prehospital setting.”
The SFD is a professional, full-time department serving the town’s 18,575 residents. With 32 members working 24-hour shifts, the department operates as a paramedic-level, fire-based EMS provider from its headquarters.
“We currently operate three ALS ambulances, one ALS fire engine, one ladder truck, one tanker, one boat, one Jet Ski, and two brush trucks,” Curalov said. “Being an all-hazard organization, the department responds to a variety of calls, most of which are for emergency medical services. As an EMS-driven and innovative organization, we not only have prehospital antibiotics, but are fortunate enough to have state-of-the-art equipment to better treat our community. We also carry disposable BiPAP devices, video laryngoscopes, Norepinephrine (Levophed), and IV pumps.”
A Legacy of Innovation
The SFD has a strong history of advancing prehospital medical care. “This is a core part of our mission,” Curalov said. “Our current practices and structure demonstrate a commitment to being a leader in this field.”
The SFD transitioned to being a full-time, professional fire-based EMS provider in the late 1990s, with all personnel being cross-trained as firefighters and paramedics. “Furthermore, when a local community hospital ended its paramedic program, the Sharon Fire Department was the first in the area to hire paramedics, became an ALS service, and adopt Cardiocerebral Resuscitation (CCR) in certain cases,” said Curalov.
The Science Behind the Decision
The SFD’s decision to administer prehospital antibiotics is based on solid medical science.
“This program was inspired by our understanding that sepsis and septic shock are a major public health concern with high mortality rates,” Curalov said. “Furthermore, research has shown a correlation between the time to antibiotic administration and patient outcomes. Our goal is to improve patient care in the field and directly and immediately impact the health of those septic patients, potentially reducing their hospital and ICU stays while improving their chances of survival.”
Putting the Protocol into Practice
As it offers prehospital antibiotic treatment, the SFD is mindful of state regulations and the need to do so in a safe and responsible manner. “The program works by using strict criteria for identifying patients who might benefit from prehospital antibiotics,” said Curalov. “This is a crucial step to avoid over-prescribing and contributing to antibiotic resistance. Paramedics are trained to use specific protocols to identify the signs and symptoms of a serious bacterial infection, such as sepsis.”
To be eligible for prehospital antibiotic treatment, the patient must be 15 years old or older, with a suspected infection source and a documented temperature of either <96.8 OR >100.4 degrees Fahrenheit.
“Patients must also have a systolic blood pressure (SBP) lower than 100 mmHg or a mean arterial pressure (MAP) under 65 and at least one of the following: a respiratory rate higher than 22 breaths per minute, a new onset of altered mental status, and a Lactate measurement at or above 4.0,” Curalov said.
Early Days
Given that the SFD’s prehospital antibiotics treatment program just started, early results are small. “Currently, we have used this program once,” said Curalov. “Our medical director stated that the patient's condition had improved.”
Looking ahead, Curalov plans to continue improving paramedics' knowledge of sepsis, septic shock, prehospital antibiotics, and blood cultures through professional development.
“We will continue to include ongoing training to keep skills sharp and introduce new and approved procedures and equipment to the organization,” he said. “This could involve training on new technologies, such as the use of AI in Point-of-Care Ultrasound (POCUS).”
Curalov said other departments wanting to start a similar program should form relationships with the local hospital, lab, and pharmacy. “If you try to do this alone, it will be twice as hard and take twice as long. When we work together looking out for one another, things run smoothly and efficiently,” he said.
