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Blood gas and electrolyte analysis in prehospital emergency medicine – first experiences
Critical Care volume 1, Article number: P112 (1997)
Background
Oxygenation and ventilation are important factors in the treatment of prehospital emergency patients. With non-invasive methods such as pulse oxymetry and capnometry the ability to obtain reliable measurements assessing oxygenation and ventilation can be limited by abnormal physiologic states commonly seen in emergency patients. In addition optimization of the electrolyte status, especially potassium and ionized calcium is important in the treatment of arrhythmias and cardiac failure. During resuscitation, knowledge of the pH is essential for correcting acidosis by giving bicarbonate.
Methods
Arterial blood was drawn from 21 prehospital emergency patients (age 16 to 90) at the site of the emergency. Blood gases and electrolytes were analysed immediately with three new, portable blood analysing devices ('IRMA', Diametrics).
Results
In 19 of the 21 cases the knowledge of the blood gases, pH and electrolytes was considered to be helpful for the emergency physician. The therapeutic consequences were intubation or the decision that no intubation is necessary, correction of ventilation, puffering with bicarbonate and substitution of electrolytes (potassium, calcium).
Conclusion
There are several indications for the use of a blood analysis in prehospital emergency situations. If we define prehospital emergency medicine as an early intensive care medicine, the knowledge of a few parameters (blood gases, pH, electrolytes, lactate) is essential for diagnosis and therapy.
References
Urban P, Scheidegger D, et al: Cardiac arrest and blood ionized calcium levels. Ann Intern Med. 1988, 15: 110-113.
Idris AH, Staples ED, et al: Effect of ventilation on acid-base balance and oxygenation in low blood flow status. Crit Care Med. 1994, 22: 1827-1834.
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Prause, G., Ratzenhofer-Komenda, B., Lauda, P. et al. Blood gas and electrolyte analysis in prehospital emergency medicine – first experiences. Crit Care 1 (Suppl 1), P112 (1997). https://doi.org/10.1186/cc3857
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DOI: https://doi.org/10.1186/cc3857