• Gernot Wildner, Nina Pauker, Sylvia Archan, Geza Gemes, Marcel Rigaud, Mirjam Pocivalnik, and Gerhard Prause.
• Department of Anaesthesiology and Intensive Care Medicine, Medical University of Graz, Graz, Austria. gernot.wildner@medunigraz.at
• Resuscitation. 2011 Sep 1;82(9):1198-201.

Background And Aim Of The StudyArterial lines are widely used in operating rooms, critical care and emergency departments. Although invasive arterial blood pressure monitoring and arterial blood gas analysis are prehospitally available, the use of arterial lines in the field remains an exception. This study evaluates the feasibility, indications and therapeutic consequences of prehospital arterial line insertion.MethodsProspective observational study in four physician-staffed emergency medical systems (EMS), documenting patient status, indications, location of puncture, number of tries and time for puncture and therapeutic consequences.ResultsDuring the one-year observation period, arterial line placement succeeded in 115 (83.9%) of 137 patients. The median time for successful arterial cannulation was 2 min (IQR 1, 3 min; range: 30-600s), for preparing the invasive blood pressure monitoring 3 min (IQR 2, 4 min, range: 30-600s). Main indications were cardiopulmonary resuscitation (36.5%), post-resuscitation care (16.8%), respiratory insufficiency (24.1%) and unconsciousness (22.6%). Therapeutic consequences depended on whether the EMS was equipped with a blood gas analyzer or not and were, overall, reported in 51.3% of patients: fluids, vasoactive or antihypertensive therapy, correction of ventilation or acidosis. No complications occurred during the prehospital phase.ConclusionThe insertion of arterial lines is feasible under prehospital conditions, without delaying or complicating patient care. Indications originating from intrahospital use are also valid in the field. In particular when combined with arterial blood gas measurement, the use of arterial lines often leads to important therapeutic consequences.Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

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