TY - JOUR
T1 - Prehospital coagulation measurement by a portable blood analyzer in a helicopter emergency medical service (HEMS)
AU - Schober, Patrick
AU - Bossers, Sebastiaan M.
AU - Koolwijk, Jasper
AU - Terra, Maartje
AU - Schwarte, Lothar A.
N1 - Publisher Copyright: © 2021 The Authors Copyright: Copyright 2021 Elsevier B.V., All rights reserved.
PY - 2021/4/19
Y1 - 2021/4/19
N2 - In helicopter emergency medical services, HEMS, coagulopathy presents both in trauma (e.g. consumption of coagulation factors) and non-trauma cases (e.g. anticoagulant use). Therefore, in HEMS coagulation measurements appear promising and Prothrombin Time (PT) and derived INR are attractive variables herein. We tested the feasibility of prehospital PT/INR coagulation measurements in HEMS. This study was performed at the Dutch HEMS, using a portable blood analyzer (i-Stat®1, Abbott). PT/INR measurements were performed on (hemodiluted) author's blood, and both trauma- and non-trauma HEMS patients. Device-related benefits of the i-Stat PT/INR system were portability, speed and ease of handling. Limitations included a rather narrow operational temperature range (16–30 °C). PT/INR measurements (n = 15) were performed on hemodiluted blood, and both trauma and non-trauma patients. The PT/INR results confirmed effects of hemodilution and anticoagulation, however, most measurement results were in the normal INR-range (0.9–1.2). We conclude that prehospital PT/INR measurements, although with limitations, are feasible in HEMS operations.
AB - In helicopter emergency medical services, HEMS, coagulopathy presents both in trauma (e.g. consumption of coagulation factors) and non-trauma cases (e.g. anticoagulant use). Therefore, in HEMS coagulation measurements appear promising and Prothrombin Time (PT) and derived INR are attractive variables herein. We tested the feasibility of prehospital PT/INR coagulation measurements in HEMS. This study was performed at the Dutch HEMS, using a portable blood analyzer (i-Stat®1, Abbott). PT/INR measurements were performed on (hemodiluted) author's blood, and both trauma- and non-trauma HEMS patients. Device-related benefits of the i-Stat PT/INR system were portability, speed and ease of handling. Limitations included a rather narrow operational temperature range (16–30 °C). PT/INR measurements (n = 15) were performed on hemodiluted blood, and both trauma and non-trauma patients. The PT/INR results confirmed effects of hemodilution and anticoagulation, however, most measurement results were in the normal INR-range (0.9–1.2). We conclude that prehospital PT/INR measurements, although with limitations, are feasible in HEMS operations.
KW - Coagulation
KW - Helicopter
KW - INR
KW - PT
KW - Prehospital
KW - Trauma
UR - http://www.scopus.com/inward/record.url?scp=85105602879&partnerID=8YFLogxK
U2 - https://doi.org/10.1016/j.ajem.2021.04.023
DO - https://doi.org/10.1016/j.ajem.2021.04.023
M3 - Article
C2 - 33906029
SN - 0735-6757
VL - 46
SP - 137
EP - 140
JO - American Journal of Emergency Medicine
JF - American Journal of Emergency Medicine
ER -