8/9/2019 2015NAEMSP Poster (Satterlee ResQGard) FINAL.pdf

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Use of an impedance threshold device to treatprehospital hypotensionPaul A. Satterlee, MD, Jonathan W. Kamrud, NREMT-P, Lori L. Boland, MPH, Charles J. Lick, MD

Allina Health Emergency Medical Services, St. Paul, MN

LIMITATIONSLack of standardization of vital sign intervals ordocumentation about ITD tolerance

No control group of similar patients who did notreceive ITD

No covariate adjustment

Device use was at the discretion of the clinician

METHODS(cont.)Data Collection

Prehospital records reviewed by a single paramedic

Pre-ITD value = last value recorded by paramedicsprior to ITD placement

Post-ITD value = first value recorded byparamedics after ITD placement

RESULTS147 device uses reviewed

The most common etiologies were syncope andweakness

Among 70 patients for whom device tolerance wasdocumented, 23% required device removal.

On average, SBP increased 15 mmHg, and DBPincreased 9 mmHg with ITD placement.

Observed increases in blood pressure wereindependent of administration of prehospitalintravenous fluids.

Variable

Age, y 66.5 (16)Male 48% (70)Received prehospital IV Fluids 42% (62)EtiologySyncope 27% (39)Weakness 16% (23)Unknown 15% (22)Hemorrhage Non-Trauma 11% (16)Other 10% (14)Dehydration 10% (14)Sepsis 5% (7)

Overdose 4% (6)Intra or Post Dialysis 3% (5)Hemorrhage Trauma 1% (1)Patient ToleranceIntolerance, device removed 11% (16)Intolerance, use continued 10% (14)Tolerated 27% (40)Unable to determine 52% (77)

VariableMean

Pre-ITDMean

Post-ITDMean

Changep-Valuea

SBP (mmHg) 77 93 +15.4