Utility of Point-of-Care Blood Testing During Cardiac Arrest: A Survey of Advanced Cardiac Life Support Team Leaders

Background: Point-of-care blood testing for multiple parameters (POCT) during cardiac arrests is routinely practiced at many hospitals, though it is not included in Advanced Cardiac Life Support (ACLS) guidelines. Objective: We aimed to study the perceived utility of POCT to ACLS team leaders. Methods: An electronic survey was administered to ACLS team leaders at two teaching hospitals – Mayo Clinic, Rochester, MN (MCR), where POCT is routinely used, and Mount Sinai St. Luke’s-Roosevelt, New York, NY (SLR), where POCT is not used. Questions included participants’ current role, experience as ACLS leaders and prior experience with POCT, as well as questions on perceived positive and negative aspects of POCT use during ACLS. For SLR providers, questions were framed as hypothetical situations if POCT results were provided two minutes after drawing blood. Results: Complete responses were received from 45 and 27 respondents at MCR and SLR, respectively. Mean number of ACLS events led were similar (48.2 vs 64.6, p=0.29), prior experience with POCT was higher at MCR (58% vs 19%, p=0.001). Out of all 11 POCT results, MCR providers perceived more parameters to be useful (6.2 vs 4.8, p=0.047). MCR providers felt POCT changed management more often and improved patient care overall (p<0.001 for both), and POCT would not cause distraction (p=0.001) or information overload (p<0.001). Conclusions: ACLS providers differed significantly in their perceived utility of POCT during cardiac arrests. The bias introduced by the practice setting and prevalent culture regarding POCT likely explains the differences between the two groups.