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Prehospital care
Invasive arterial blood pressure monitoring in an out-of-hospital setting: an observational study
  1. J Sende1,
  2. P Jabre1,2,
  3. B Leroux1,
  4. C Penet1,
  5. E Lecarpentier1,
  6. M Khalid1,
  7. A Margenet1,
  8. J Marty1,
  9. X Combes1
  1. 1
    Service d’Anesthésie Réanimation et SAMU 94, Henri Mondor University Hospital (AP-HP), Créteil, France
  2. 2
    EA 3409, Avicenne University Hospital (AP-HP), Bobigny, France
  1. Dr X Combes, SAMU 94, CHU H Mondor (AP-HP), 94000 Créteil, France; xavier.combes{at}hmn.aphp.fr

Abstract

Background: Non-invasive arterial blood pressure measurement is often inaccurate in emergency unstable patients. A study was undertaken to assess the feasibility of out-of-hospital intra-arterial catheterisation in haemodynamically unstable patients and to evaluate the correlation between invasive and non-invasive arterial pressure values.

Methods: In this prospective 2-year observational study conducted by mobile emergency medical units, the success rate of arterial catheterisation was calculated and blood pressure values measured invasively and non-invasively after successful catheterisation were compared.

Results: 94 patients were included. The success rate for catheterisation (44 radial access, 50 femoral access) was 86% (95% CI 79% to 93%). Bias and precision in invasive versus non-invasive comparisons were −0.1, 38 mm Hg for systolic pressure and 4.2, 27 mm Hg for diastolic pressure. Values differed by more than 20 mm Hg in over 40% of patients. Invasive measurement led to 79 changes in vasoactive treatment in 51 patients.

Conclusion: Emergency out-of-hospital invasive arterial blood pressure monitoring in haemodynamically unstable patients is highly feasible. Discrepancies between invasive and non-invasive measurements are common and highlight the value of early out-of-hospital monitoring.

https://doi.org/10.1136/emj.2008.060608

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    Footnotes

    • Funding: Support from hospital department sources only.

    • Competing interests: None.

    • Ethics approval: The study was approved by the local ethics committee who waived informed consent because only routine care was given without any randomisation.