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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