Volume : 12, Issue : 10, October – 2025
Title:
POINT-OF-CARE COAGULATION MONITORING IN THE AMBULANCE: A SCOPING REVIEW OF ITS POTENTIAL TO GUIDE HEMOSTATIC RESUSCITATION
Authors :
Hatem Eid Mubarak Alsahli, Yasser Abeed Awad Al Sehli, Faisal Reshaid Marshood Alsahli, Adnan Awadh Hameed Alsahli, Atiah Ruwaybih Eawadah Alluqmani, Sami Owaid Oraymit Aloufi, Sulaiman Abdullah Alshohaib, Obaid Muteb Almutairi, Ayed Jobran Alghamdi, Saqer Ali Alqarni
Abstract :
Uncontrolled hemorrhage is a leading cause of preventable prehospital death. While point-of-care (POC) coagulation monitoring, particularly viscoelastic hemostatic assays (VHA), has transformed in-hospital hemostatic resuscitation, its potential in the ambulance setting remains uncertain. This scoping review aimed to map the existing evidence on the feasibility, accuracy, and impact of POC coagulation monitoring in ambulance services to guide hemostatic resuscitation. A scoping review was conducted following the Joanna Briggs Institute (JBI) methodology and PRISMA-ScR guidelines. A systematic search of multiple databases (e.g., PubMed, Embase, Scopus) was performed to identify studies involving POC coagulation testing in ground or air ambulances. Data from included studies were charted and synthesized narratively. Of 2,548 identified records, 23 studies were included. The evidence demonstrates that POC devices like TEG and ROTEM are technically feasible for use in ambulances and helicopters, with trained prehospital personnel obtaining results that correlate with in-hospital standards. Case reports indicate potential for guiding tranexamic acid administration and alerting trauma teams. However, the literature is dominated by small observational and feasibility studies. Direct evidence of a significant impact on clinical management is limited, and no studies demonstrate improved patient-centered outcomes such as mortality. POC coagulation monitoring in the ambulance is a feasible and promising technology that could close the “therapeutic gap” in early hemorrhage control. It holds potential for personalizing prehospital resuscitation and improving trauma system efficiency. However, the current evidence base is insufficient to support widespread implementation. Future research must prioritize large-scale randomized controlled trials to establish efficacy, cost-effectiveness, and develop prehospital-specific treatment algorithms.
Keywords: Point-of-Care Testing, Prehospital Care, Hemorrhage, Resuscitation, Thromboelastography, Trauma
Cite This Article:
Please cite this article in press Hatem Eid Mubarak Alsahli et al., Point-Of-Care Coagulation Monitoring In The Ambulance: A Scoping Review Of Its Potential To Guide Hemostatic Resuscitation, Indo Am. J. P. Sci, 2025; 12(10).
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