Utilization of Multi-Parameter Blood Gas Analysis in Prehospital Emergency Medicine—A Scoping Review

IF 1.2 4区 医学 Q3 EMERGENCY MEDICINE Journal of Emergency Medicine Pub Date : 2024-05-09 DOI:10.1016/j.jemermed.2024.04.014
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Abstract

Background

Prehospital blood gas analysis (BGA) is an evolving field that offers the potential for early identification and management of critically ill patients. However, the utility and accuracy of prehospital BGA are subjects of ongoing debate.

Objectives

We aimed to provide a comprehensive summary of the current literature on prehospital BGA, including its indications, methods, and feasibility.

Methods

We performed a scoping review of prehospital BGA. A thorough search of the PubMed, Embase, and Web of Science databases was conducted to identify relevant studies focusing on prehospital BGA in adult patients.

Results

Fifteen studies met the inclusion criteria. Prehospital BGA was most frequently performed in patients in out-of-hospital cardiac arrest, followed by traumatic and nontraumatic cases. The parameters most commonly analyzed were pH, pCO2, pO2, and lactate. Various sampling methods, including arterial, venous, and intraosseous, were reported for prehospital BGA. While prehospital BGA shows promise in facilitating early identification of critical patients and guiding resuscitation efforts, logistical challenges are to be considered. The handling of preclinical BGA is described as feasible and useful in most of the included studies.

Conclusion

Prehospital BGA holds significant potential for enhancing patient care in the prehospital setting, though technical challenges need to be considered. However, further research is required to establish optimal indications and demonstrate the benefits for prehospital BGA in specific clinical contexts.

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院前急救医学中多参数血气分析的应用--范围审查
背景院前血气分析(BGA)是一个不断发展的领域,它为危重病人的早期识别和管理提供了可能。然而,院前血气分析的实用性和准确性一直是争论的焦点。目的我们旨在全面总结目前有关院前血气分析的文献,包括其适应症、方法和可行性。我们对 PubMed、Embase 和 Web of Science 数据库进行了全面检索,以确定关于成人患者院前 BGA 的相关研究。院前 BGA 最常在院外心脏骤停患者中进行,其次是创伤性和非创伤性病例。最常分析的参数是 pH、pCO2、pO2 和乳酸盐。院前 BGA 的取样方法多种多样,包括动脉、静脉和骨内取样。虽然院前 BGA 有助于早期识别危重病人和指导复苏工作,但也要考虑到后勤方面的挑战。结论院前 BGA 在加强院前环境中的病人护理方面具有巨大潜力,但需要考虑技术挑战。然而,要确定最佳适应症并证明院前 BGA 在特定临床环境中的益处,还需要进一步的研究。
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来源期刊
Journal of Emergency Medicine
Journal of Emergency Medicine 医学-急救医学
CiteScore
2.40
自引率
6.70%
发文量
339
审稿时长
2-4 weeks
期刊介绍: The Journal of Emergency Medicine is an international, peer-reviewed publication featuring original contributions of interest to both the academic and practicing emergency physician. JEM, published monthly, contains research papers and clinical studies as well as articles focusing on the training of emergency physicians and on the practice of emergency medicine. The Journal features the following sections: • Original Contributions • Clinical Communications: Pediatric, Adult, OB/GYN • Selected Topics: Toxicology, Prehospital Care, The Difficult Airway, Aeromedical Emergencies, Disaster Medicine, Cardiology Commentary, Emergency Radiology, Critical Care, Sports Medicine, Wound Care • Techniques and Procedures • Technical Tips • Clinical Laboratory in Emergency Medicine • Pharmacology in Emergency Medicine • Case Presentations of the Harvard Emergency Medicine Residency • Visual Diagnosis in Emergency Medicine • Medical Classics • Emergency Forum • Editorial(s) • Letters to the Editor • Education • Administration of Emergency Medicine • International Emergency Medicine • Computers in Emergency Medicine • Violence: Recognition, Management, and Prevention • Ethics • Humanities and Medicine • American Academy of Emergency Medicine • AAEM Medical Student Forum • Book and Other Media Reviews • Calendar of Events • Abstracts • Trauma Reports • Ultrasound in Emergency Medicine
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