The role of point-of-care testing in cardiac arrest patients
Point-of-care testing (POCT) provides real time information to the clinical team, leading to early diagnosis and treatment. Whether POCT plays a role in improving outcomes in patients with out of hospital cardiac arrest (OHCA) remains unknown. The objective of this study was to describe use of POCT...
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| Veröffentlicht in: | The American journal of emergency medicine 2023-12, Vol.74, p.32-35 |
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| creator | Rampersaud, Vishnu M. Barberis, Trinity Thode, Henry C. Singer, Adam J. |
| description | Point-of-care testing (POCT) provides real time information to the clinical team, leading to early diagnosis and treatment. Whether POCT plays a role in improving outcomes in patients with out of hospital cardiac arrest (OHCA) remains unknown. The objective of this study was to describe use of POCT in OHCA and to explore its association with outcomes.
We conducted a retrospective chart review on patients transferred by emergency medical services (EMS) to the ED for out-of-hospital cardiac arrest (OHCA) in 2019. Data collected from patient charts included baseline information, the Utstein criteria for cardiac arrest, whether POCT was used, whether POCT was abnormal, and what treatment was given, if any, as a result of the abnormal POCT. Outcomes included return of spontaneous circulation (ROSC) and survival to hospital discharge. Outcomes in patients with and without POCT were compared using chi-square and t-tests.
There were 119 study patients. Their mean (SD) age was 65 (18) years and 65% were male. Cardiac arrest was witnessed in 48% and initial rhythm was asystole in 66%. The rates of ROSC and survival were 22.7% (95%CI, 16.1–31.1) and 3.4% (95%CI, 1.3–8.3). POCT was used in 66 patients (55.4%; 95%CI, 46.5–64.1) all of whom had at least one abnormality. The results of POCT led to administration of a therapy in 60 patients (91.0%; 95%CI, 81.6–95.8). The rates of ROSC in patients with and without POCT were 22.6% vs 22.7% respectively. The rates of survival to discharge in patients with and without POCT were 0% vs 3.8% respectively.
POCT is commonly used in the ED for patients with OHCA and its results often lead to changes in therapies. However, use of POCT was not associated with ROSC or survival to discharge. |
| doi_str_mv | 10.1016/j.ajem.2023.09.006 |
| format | Article |
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We conducted a retrospective chart review on patients transferred by emergency medical services (EMS) to the ED for out-of-hospital cardiac arrest (OHCA) in 2019. Data collected from patient charts included baseline information, the Utstein criteria for cardiac arrest, whether POCT was used, whether POCT was abnormal, and what treatment was given, if any, as a result of the abnormal POCT. Outcomes included return of spontaneous circulation (ROSC) and survival to hospital discharge. Outcomes in patients with and without POCT were compared using chi-square and t-tests.
There were 119 study patients. Their mean (SD) age was 65 (18) years and 65% were male. Cardiac arrest was witnessed in 48% and initial rhythm was asystole in 66%. The rates of ROSC and survival were 22.7% (95%CI, 16.1–31.1) and 3.4% (95%CI, 1.3–8.3). POCT was used in 66 patients (55.4%; 95%CI, 46.5–64.1) all of whom had at least one abnormality. The results of POCT led to administration of a therapy in 60 patients (91.0%; 95%CI, 81.6–95.8). The rates of ROSC in patients with and without POCT were 22.6% vs 22.7% respectively. The rates of survival to discharge in patients with and without POCT were 0% vs 3.8% respectively.
POCT is commonly used in the ED for patients with OHCA and its results often lead to changes in therapies. However, use of POCT was not associated with ROSC or survival to discharge.</description><identifier>ISSN: 0735-6757</identifier><identifier>EISSN: 1532-8171</identifier><identifier>DOI: 10.1016/j.ajem.2023.09.006</identifier><language>eng</language><publisher>Philadelphia: Elsevier Inc</publisher><subject>Anemia ; Cardiac arrest ; Cardiopulmonary resuscitation ; Clinical outcomes ; CPR ; Electrolytes ; Emergency medical care ; Emergency medical services ; Heart ; Hyperkalemia ; Out of hospital cardiac arrest ; Patients ; Point of care testing ; Survival</subject><ispartof>The American journal of emergency medicine, 2023-12, Vol.74, p.32-35</ispartof><rights>2023 Elsevier Inc.</rights><rights>2023. Elsevier Inc.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c312t-880d5ef787751147dd7ceaf85ae8ec583cf1e6ea9be3233558716efd24aee833</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.proquest.com/docview/2891741618?pq-origsite=primo$$EHTML$$P50$$Gproquest$$H</linktohtml><link.rule.ids>315,781,785,3551,27929,27930,46000,64390,64392,64394,72474</link.rule.ids></links><search><creatorcontrib>Rampersaud, Vishnu M.</creatorcontrib><creatorcontrib>Barberis, Trinity</creatorcontrib><creatorcontrib>Thode, Henry C.</creatorcontrib><creatorcontrib>Singer, Adam J.</creatorcontrib><title>The role of point-of-care testing in cardiac arrest patients</title><title>The American journal of emergency medicine</title><description>Point-of-care testing (POCT) provides real time information to the clinical team, leading to early diagnosis and treatment. Whether POCT plays a role in improving outcomes in patients with out of hospital cardiac arrest (OHCA) remains unknown. The objective of this study was to describe use of POCT in OHCA and to explore its association with outcomes.
We conducted a retrospective chart review on patients transferred by emergency medical services (EMS) to the ED for out-of-hospital cardiac arrest (OHCA) in 2019. Data collected from patient charts included baseline information, the Utstein criteria for cardiac arrest, whether POCT was used, whether POCT was abnormal, and what treatment was given, if any, as a result of the abnormal POCT. Outcomes included return of spontaneous circulation (ROSC) and survival to hospital discharge. Outcomes in patients with and without POCT were compared using chi-square and t-tests.
There were 119 study patients. Their mean (SD) age was 65 (18) years and 65% were male. Cardiac arrest was witnessed in 48% and initial rhythm was asystole in 66%. The rates of ROSC and survival were 22.7% (95%CI, 16.1–31.1) and 3.4% (95%CI, 1.3–8.3). POCT was used in 66 patients (55.4%; 95%CI, 46.5–64.1) all of whom had at least one abnormality. The results of POCT led to administration of a therapy in 60 patients (91.0%; 95%CI, 81.6–95.8). The rates of ROSC in patients with and without POCT were 22.6% vs 22.7% respectively. The rates of survival to discharge in patients with and without POCT were 0% vs 3.8% respectively.
POCT is commonly used in the ED for patients with OHCA and its results often lead to changes in therapies. However, use of POCT was not associated with ROSC or survival to discharge.</description><subject>Anemia</subject><subject>Cardiac arrest</subject><subject>Cardiopulmonary resuscitation</subject><subject>Clinical outcomes</subject><subject>CPR</subject><subject>Electrolytes</subject><subject>Emergency medical care</subject><subject>Emergency medical services</subject><subject>Heart</subject><subject>Hyperkalemia</subject><subject>Out of hospital cardiac arrest</subject><subject>Patients</subject><subject>Point of care testing</subject><subject>Survival</subject><issn>0735-6757</issn><issn>1532-8171</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2023</creationdate><recordtype>article</recordtype><sourceid>8G5</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><sourceid>GUQSH</sourceid><sourceid>M2O</sourceid><recordid>eNp9kE1LxDAQhoMouK7-AU8BL15a89F8FPYii1-w4GXvIaYTTek2NekK_nuzrCcPnoYZ3nfmnQeha0pqSqi862vbw65mhPGatDUh8gQtqOCs0lTRU7QgiotKKqHO0UXOPSGUNqJZoNX2A3CKA-Do8RTDOFfRV84mwDPkOYzvOIy49F2wDtuUyhBPdg4wzvkSnXk7ZLj6rUu0fXzYrp-rzevTy_p-UzlO2VxpTToBXmmlRDmruk45sF4LCxqc0Nx5ChJs-waccS6EVlSC71hjATTnS3R7XDul-LkvAcwuZAfDYEeI-2yYli1jTJbnl-jmj7SP-zSWcEXVUtVQSXVRsaPKpZhzAm-mFHY2fRtKzIGn6c2BpznwNKQ1hWcxrY4mKJ9-BUgmu0LBQRcSuNl0Mfxn_wGgR30p</recordid><startdate>202312</startdate><enddate>202312</enddate><creator>Rampersaud, Vishnu M.</creator><creator>Barberis, Trinity</creator><creator>Thode, Henry C.</creator><creator>Singer, Adam J.</creator><general>Elsevier Inc</general><general>Elsevier Limited</general><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7T5</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>8G5</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>GUQSH</scope><scope>H94</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>M1P</scope><scope>M2O</scope><scope>MBDVC</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>Q9U</scope><scope>7X8</scope></search><sort><creationdate>202312</creationdate><title>The role of point-of-care testing in cardiac arrest patients</title><author>Rampersaud, Vishnu M. ; Barberis, Trinity ; Thode, Henry C. ; Singer, Adam J.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c312t-880d5ef787751147dd7ceaf85ae8ec583cf1e6ea9be3233558716efd24aee833</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2023</creationdate><topic>Anemia</topic><topic>Cardiac arrest</topic><topic>Cardiopulmonary resuscitation</topic><topic>Clinical outcomes</topic><topic>CPR</topic><topic>Electrolytes</topic><topic>Emergency medical care</topic><topic>Emergency medical services</topic><topic>Heart</topic><topic>Hyperkalemia</topic><topic>Out of hospital cardiac arrest</topic><topic>Patients</topic><topic>Point of care testing</topic><topic>Survival</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Rampersaud, Vishnu M.</creatorcontrib><creatorcontrib>Barberis, Trinity</creatorcontrib><creatorcontrib>Thode, Henry C.</creatorcontrib><creatorcontrib>Singer, Adam J.</creatorcontrib><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Nursing & Allied Health Database</collection><collection>Immunology Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>Research Library (Alumni Edition)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>Research Library Prep</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Research Library</collection><collection>Research Library (Corporate)</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central Basic</collection><collection>MEDLINE - Academic</collection><jtitle>The American journal of emergency medicine</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Rampersaud, Vishnu M.</au><au>Barberis, Trinity</au><au>Thode, Henry C.</au><au>Singer, Adam J.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>The role of point-of-care testing in cardiac arrest patients</atitle><jtitle>The American journal of emergency medicine</jtitle><date>2023-12</date><risdate>2023</risdate><volume>74</volume><spage>32</spage><epage>35</epage><pages>32-35</pages><issn>0735-6757</issn><eissn>1532-8171</eissn><abstract>Point-of-care testing (POCT) provides real time information to the clinical team, leading to early diagnosis and treatment. Whether POCT plays a role in improving outcomes in patients with out of hospital cardiac arrest (OHCA) remains unknown. The objective of this study was to describe use of POCT in OHCA and to explore its association with outcomes.
We conducted a retrospective chart review on patients transferred by emergency medical services (EMS) to the ED for out-of-hospital cardiac arrest (OHCA) in 2019. Data collected from patient charts included baseline information, the Utstein criteria for cardiac arrest, whether POCT was used, whether POCT was abnormal, and what treatment was given, if any, as a result of the abnormal POCT. Outcomes included return of spontaneous circulation (ROSC) and survival to hospital discharge. Outcomes in patients with and without POCT were compared using chi-square and t-tests.
There were 119 study patients. Their mean (SD) age was 65 (18) years and 65% were male. Cardiac arrest was witnessed in 48% and initial rhythm was asystole in 66%. The rates of ROSC and survival were 22.7% (95%CI, 16.1–31.1) and 3.4% (95%CI, 1.3–8.3). POCT was used in 66 patients (55.4%; 95%CI, 46.5–64.1) all of whom had at least one abnormality. The results of POCT led to administration of a therapy in 60 patients (91.0%; 95%CI, 81.6–95.8). The rates of ROSC in patients with and without POCT were 22.6% vs 22.7% respectively. The rates of survival to discharge in patients with and without POCT were 0% vs 3.8% respectively.
POCT is commonly used in the ED for patients with OHCA and its results often lead to changes in therapies. However, use of POCT was not associated with ROSC or survival to discharge.</abstract><cop>Philadelphia</cop><pub>Elsevier Inc</pub><doi>10.1016/j.ajem.2023.09.006</doi><tpages>4</tpages></addata></record> |
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| subjects | Anemia Cardiac arrest Cardiopulmonary resuscitation Clinical outcomes CPR Electrolytes Emergency medical care Emergency medical services Heart Hyperkalemia Out of hospital cardiac arrest Patients Point of care testing Survival |
| title | The role of point-of-care testing in cardiac arrest patients |
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