Prehospital point of care testing of blood gases and electrolytes — an evaluation of IRMA

Gerhard Prause , Beatrice Ratzenhofer-Komenda, Anton Offner, Peter Lauda, Henrika Voit and Horst Pojer

Department of Anesthesiology and Critical Care Medicine, University of Graz, Auenbruggerplatz 29, A-8036 Graz, Austria

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Critical Care 1997, 1:79-83doi:10.1186/cc108


Published:	26 November 1997

Abstract

Background

This study evaluated the feasibility of blood gas analysis and electrolyte measurements during emergency transport prior to hospital admission.

Results

A portable, battery-powered blood analyzer was used on patients in life threatening conditions to determine pH, pCO₂, pO₂, sodium, potassium and ionized calcium. Arterial blood was used for blood gas analysis and electrolyte measurements. Venous blood was used for electrolyte measurement alone. During the observation period of 4 months, 32 analyses were attempted on 25 patients. Eleven measurements (34%) could not be performed due to technical failure. Overall, 25 samples taken from 21 patients were evaluated. The emergency physicians (all anesthesiologists) considered the knowledge of blood gases and/or electrolytes to be helpful in 72% of cases. This knowledge led to immediate therapeutic consequences in 52% of all cases. After a short training and familiarization session the handling of the device was found to be problem free.

Conclusions

We concluded that knowledge of the patients' pH, pCO₂ and pO₂ in life threatening situations yields more objective information about oxygenation, carbon dioxide and acid-base regulation than pulse oximetry and/or capnometry alone. Additionally, it enables physicians to correct severe hypokalemia or hypocalcemia in cases of cardiac failure or malignant arrhythmia.