• Cornelis Slagt, Sjoerd Servaas, Rein Ketelaars, Geert-Jan van Geffen, Marijn Cornelia Theresia Tacken, Corien Alexandra Verrips, Lonneke Ankie Marcel Baggen, Gert Jan Scheffer, and Lucas Theodorus van Eijk.
• Department of Anesthesiology, Pain and Palliative Medicine, Radboud University Nijmegen Medical Centre, Geert Grooteplein Zuid 10, Huispost 717, route 714, Postbus 9101, 6500 HB, Nijmegen, The Netherlands. cor.slagt@radboudumc.nl.
• J Clin Monit Comput. 2022 Apr 1; 36 (2): 363-370.

PurposeIntroducing advanced hemodynamic monitoring might be beneficial during Helicopter Emergency Medical Service (HEMS) care. However, it should not increase the on-scene-time, it should be easy to use and should be non-invasive. The goal of this study was to investigate the feasibility of non-invasive cardiac output measurements by electrical cardiometry (EC) and the quality of the EC signal during pre-hospital care provided by our HEMS.MethodsA convenience sample of fifty patients who required HEMS assistance were included in this study. Problems with respect to connecting the patient, entering patient characteristics and measuring were inventoried. Quality of EC signal of the measurements was assessed during prehospital helicopter care. We recorded the number of measurements with a signal quality indicator (SQI) ≥ 80 and the number of patients having at least 1 measurement with a SQI ≥ 80. Furthermore, the SQI value distribution of the measurements within each patient was analysed.ResultsIn the experience of the attending HEMS caregivers application of the device was easy and did not result in increased duration of on-scene time. Patch adhesion was reported as a concern due to clammy skin in 22% of all cases. 684 measurements were recorded during HEMS care. In 47 (94%) patients at least 1 measurement with an SQI ≥ 80 was registered. Of all recorded measurements 5.8% had an SQI < 40, 11.4% had an SQI 40-59, 14.9% had a SQI between 60 and 79 and 67.8% had SQI ≥ 80.ConclusionCardiac output measurements are feasible during prehospital HEMS care with good quality of the EC signal. Monitoring was easy to use and quick to install. In our view it is an promising candidate for the prehospital setting. Further research is needed to determine its clinical value during clinical decision making.© 2021. The Author(s).

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