• Patrick Schober, Sebastiaan M Bossers, Jasper Koolwijk, Maartje Terra, and Lothar A Schwarte.
• Department of Anesthesiology, Amsterdam University Medical Center, Amsterdam, Netherlands; HEMS Life Liner 1, Amsterdam University Medical Center, Amsterdam, Netherlands.
• Am J Emerg Med. 2021 Aug 1; 46: 137-140.

AbstractIn 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.Copyright © 2021 The Authors. Published by Elsevier Inc. All rights reserved.

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