PREHOSPITAL BLOOD-GAS ANALYSIS - TECHNICA L DESCRIPTION FIRST EXPERIENCES - INDICATIONS

Objective. A new portable device for blood gas analyses (BCA) has been examined for prehospital application. Methods. After a 1 h introducti on to the procedure, two physicians used the blood gas analyzer in the emergency medical system in Graz, Austria, for 7 months. The indicati ons for prehospital EGA were prolonged cardiopulmonary resuscitation, mechanical ventilation, hyperventilation for reducing increased intrac ranial pressure, respiratory failure and metabolic disorders, All pati ents tested were also checked with pulse oximetry and capnography. Tec hnical specification. The device measures pO(2), pCO(2) and pH using t he fluorescence method, The innovation of a single-use cassette system makes it unnecessary to do any calibrations or transport any test sub stances. The storage battery measures eight samples without recharge, The time spent on one measurement is 3-6 min. Results. We took 49 samp les from 24 patients and found 16 indications for therapeutical interv ention, such as buffering metabolic acidosis and adjusting mechanical ventilation by means of EGA. In all cases the analyzer worked reliably . Conclusions. One advantage of EGA over the non-invasive methods puls e oximetry and capnography is that it does not interfere with factors like peripheral vasoconstriction or inequality of the pulmonary ventil ation/perfusion ratio. Moreover, it is the only method for controlled buffering of acid-base disturbances. This means more security in diagn ostics and therapeutical interventions for the patient in danger of dy ing. The device has proved to be a useful addition to the monitoring m ethods for prehospital application.