Spot Checking Hemoglobin Saves Time in Trauma Care

Noninvasive Hemoglobin (Hbg) measurements using a spot check pulse CO-oximeter provides immediate assessment of blood loss in trauma patients, according to a new study.

Researchers at the University of Arizona (Tucson, USA) performed a prospective cohort analysis of 525 critically injured patients (74% male) presenting at the Level I trauma center. Invasive and spot check Hgb measurements were obtained simultaneously at presentation, with the spot check measured two times with each invasive Hgb value; in all, 450 patients (86%) underwent the spot check measurements successfully, for a total of 1,350 results. For the study, the researchers used the Pronto-7 spot check pulse CO-oximeter, a product of product of Masimo (Irvine, CA, USA). Normal Hgb was defined as over 8 mg/dL.


The results showed that the mean invasive Hgb was 11.5 and mean spot check Hgb was 11.1, indicating a strong correlation between spot and invasive Hgb measurements. Among the reasons cited for failed tests were nail polish on the patient’s fingernails, particulate matter—such as dust or soot—on the patient’s fingers which disrupted the sensor reading, or because the sensor did not fit the patient’s finger. In all, 38% of patients had Hgb lower than 8 mg/dL at presentation. The study was published in the January 2015 issue of the Journal of the American College of Surgeons (JACS).

“This device was initially intended for outpatient medical offices to obtain readings of people who were anemic, but the ability to get hemoglobin readings with a device that one places on the finger intrigued us,” said lead author Bellal Joseph, MD. “It can help make a medical decision very quickly about where this patient needs to go—to the operating room or intensive-care-unit—without waiting for laboratory results. It gives us immediate information that we otherwise could not get.”

Previous studies have found that up to 70% of deaths among trauma patients occurred within the first 24 hours of admission and attributed 30%–40% of trauma deaths to severe blood loss, making quick and early detection and treatment of hemorrhage in critically injured patients important in saving their lives.

The Pronto-7 spot check pulse CO-oximeter is based on noninvasive sensor technology that uses more than seven wavelengths of light to acquire blood constituent data based on light absorption. Advanced signal processing algorithms and unique adaptive filters work together to isolate, identify and quantify various hemoglobin species, delivering blood measurement results in numerical values.

Related Links:
University of Arizona
Masimo
Link to Hospimedica Pronto-7 news item