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

• Published in: The Journal of emergency medicine 2024-09, Vol.67 (3), p.e277-e287
• Main Authors: Rief, Martin, Eichinger, Michael, Eichlseder, Michael, Pichler, Alexander, Prause, Gerhard, Bornemann-Cimenti, Helmar, Zajic, Paul
• Format: Article
• Language: English
• Subjects: blood gas analysis; Blood Gas Analysis - methods; Critical Illness - therapy; diagnostic tests, routine; emergency medical services; Emergency Medical Services - methods; emergency medicine; Emergency Medicine - methods; Humans; Out-of-Hospital Cardiac Arrest - blood; Out-of-Hospital Cardiac Arrest - therapy
• ISSN: 0736-4679
• DOI: 10.1016/j.jemermed.2024.04.014

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