The following is a summary of “Role of point-of-care testing in cardiac arrest patients,” published in the December 2023 issue of Emergency Medicine by Rampersaud, et al.

Point-of-care testing (POCT) offers real-time clinical information, potentially facilitating early diagnosis and treatment. However, its impact on outcomes in out-of-hospital cardiac arrest (OHCA) patients remained uncertain.

A retrospective chart review was conducted on OHCA patients transferred by emergency medical services (EMS) to the emergency department (ED) in 2019. Data collected included baseline characteristics, Utstein criteria for cardiac arrest, POCT utilization, abnormal POCT results, subsequent treatments initiated based on POCT findings, and outcomes such as return of spontaneous circulation (ROSC) and survival to hospital discharge. Comparisons of outcomes between patients with and without POCT were made using chi-square and t-tests.

The study comprised 119 patients with a mean age of 65 years, of whom 65% were male. Witnessed cardiac arrest occurred in 48%, with asystole being the predominant initial rhythm in 66%. ROSC and survival rates were 22.7% and 3.4%, respectively. POCT was employed in 66 patients (55.4%; 95% CI, 46.5–64.1), exhibiting at least one abnormality, prompting therapy administration in 91.0% of cases (95% CI, 81.6–95.8). Rates of ROSC were similar between patients with and without POCT (22.6% vs. 22.7%, respectively), while survival to discharge rates differed (0% vs. 3.8%; 95% CI, 1.3–8.3).

POCT is frequently utilized in the ED for OHCA patients and often guides therapeutic interventions. However, its use did not correlate with improved rates of ROSC or survival to discharge.

Reference: sciencedirect.com/science/article/abs/pii/S0735675723004771