Reducing Pain in Emergency Department by Using Veinous Blood Gas Instead of Arterious Blood Gas
- Conditions
- Acid Base Disorder
- Interventions
- Diagnostic Test: Veinous blood gasDiagnostic Test: Arterial blood gas
- Registration Number
- NCT03784664
- Lead Sponsor
- Assistance Publique - H么pitaux de Paris
- Brief Summary
Blood gases are widely used in emergency and resuscitation services and are the key examination for exploring acid-base balance disorders (using pH, PaCO2 and HCO3 ) and gas exchange disorders (using PaO2 and PaCO2). This examination can be taken from both venous and arterial sample and its analysis depends on the type of blood sample. Currently, several studies have already shown the existence of a good correlation of pH and bicarbonates level between a venous and arterial sample. Thus, when this examination is prescribed for the purpose of highlighting and analyzing an acid-base disorder, venous blood gas is theoretically as efficient as arterial blood gas.
Due to the lack of evidence of benefit for the patient or the health care team of a venous blood gas rather than an arterial blood gas in the absence of suspicion of hypoxemia, arterial blood gas is currently the standard of care for the analysis of acid-base disorders. Indeed, among the university hospitals affiliated to the Paris Diderot University, the emergency departments carry out in their vast majority (4 of 5 E.D.) arterial blood gases. Demonstration of the superiority of veinous sample over arterial sample regarding pain could substantially modify current practices.
The investigator's main hypothesis is that, in the absence of suspicion of hypoxemia (normal oxygen saturation measured by plethysmography), the realization of a venous blood gas for the evaluation of the acid-base balance in the context of emergencies is less painful for patients, simpler for the health care team and provides sufficient biochemical information for the doctor in comparison with an arterial blood gas.
- Detailed Description
Not available
Recruitment & Eligibility
- Status
- COMPLETED
- Sex
- All
- Target Recruitment
- 100
- necessity of blood gas analysis
- age > 18 yo
- SpO2>95% without supplemental oxygen
- no altered level of consciousness: Glasgow Coma Scale=15
- Patient under guardianship or curatorship
- confusional state or patient unable to understand the protocol
- no social security
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- PARALLEL
- Arm && Interventions
Group Intervention Description Veinous blood gas Veinous blood gas - Arterial blood gas Arterial blood gas -
- Primary Outcome Measures
Name Time Method Pain score: Visual Analog Scale Immediately after blood gas sample Pain is self-completed by the patient using a Visual Analog Scale. Visual Analog Scale for Pain is a continuous scale comprised of a line of 100 mm grading pain intensity anchored by "no pain" (score 0) and "worst imaginable pain" (score 100)
- Secondary Outcome Measures
Name Time Method Number of attempts needed to obtain a blood gas sample Immediately after blood gas sample Quality of information provided by the blood gas analysis: four levels likert scale Immediately after having received blood gas analysis results Four-levels likert scale assessing doctor's satisfaction regarding the quality of gas information provided by the blood gas analysis ("very satisfied","satisfied","slightly satisfied","not satisfied"
Number of different operators needed to obtain a blood gas sample Immediately after blood gas sample Ease of blood gas sampling procedure Immediately after blood gas sample Ease of blood gas sampling procedure assessed by the operator using a four-levels likert scale ("easy","moderate","difficult" "very difficult")
Failure of the blood gas sampling procedure Immediately after blood gas sample Impossibility to obtain a blood gas sample
Trial Locations
- Locations (4)
H么pital Beaujon
馃嚝馃嚪Clichy, France
H么pital Louis Mourier
馃嚝馃嚪Colombes, France
H么pital Lariboisi猫re
馃嚝馃嚪Paris, France
H么pital Bichat
馃嚝馃嚪Paris, France