Department of Anesthesiology, Amsterdam University Medical Center, Amsterdam, Netherlands; HEMS Life Liner 1, Amsterdam University Medical Center, Amsterdam, Netherlands.
Department of Anesthesiology, Amsterdam University Medical Center, Amsterdam, Netherlands.
Am J Emerg Med. 2021 Aug;46:137-140. doi: 10.1016/j.ajem.2021.04.023. Epub 2021 Apr 19.
In helicopter emergency medical services, HEMS, coagulopathy presents both in trauma (e.g. consumption of coagulation factors) and non-trauma cases (e.g. anticoagulant use). Therefore, in HEMS coagulation measurements appear promising and Prothrombin Time (PT) and derived INR are attractive variables herein. We tested the feasibility of prehospital PT/INR coagulation measurements in HEMS. This study was performed at the Dutch HEMS, using a portable blood analyzer (i-Stat®1, Abbott). PT/INR measurements were performed on (hemodiluted) author's blood, and both trauma- and non-trauma HEMS patients. Device-related benefits of the i-Stat PT/INR system were portability, speed and ease of handling. Limitations included a rather narrow operational temperature range (16-30 °C). PT/INR measurements (n = 15) were performed on hemodiluted blood, and both trauma and non-trauma patients. The PT/INR results confirmed effects of hemodilution and anticoagulation, however, most measurement results were in the normal INR-range (0.9-1.2). We conclude that prehospital PT/INR measurements, although with limitations, are feasible in HEMS operations.
在直升机紧急医疗服务（HEMS）中，凝血障碍既存在于创伤（例如凝血因子消耗）病例中，也存在于非创伤病例（例如抗凝剂使用）中。因此，在 HEMS 中，凝血测量似乎很有前景，凝血酶原时间（PT）和衍生的国际标准化比值（INR）是很有吸引力的变量。我们测试了在 HEMS 中进行院前 PT/INR 凝血测量的可行性。这项研究是在荷兰 HEMS 进行的，使用了便携式血液分析仪（i-Stat®1，雅培）。PT/INR 测量是在（血液稀释的）作者的血液以及创伤和非创伤 HEMS 患者中进行的。i-Stat PT/INR 系统的设备相关优势包括便携性、速度和易于操作。局限性包括相对较窄的操作温度范围（16-30°C）。PT/INR 测量（n = 15）是在血液稀释的血液和创伤和非创伤患者中进行的。PT/INR 结果证实了血液稀释和抗凝的影响，但大多数测量结果都在正常 INR 范围内（0.9-1.2）。我们得出结论，尽管存在局限性，但院前 PT/INR 测量在 HEMS 操作中是可行的。
