Quantifying the impact of prehospital arterial line insertion on scene time

Enhanced prehospital care services, globally, have demonstrated the feasibility of establishing intra-arterial blood pressure monitoring prehospital to adapt their interventions to their patient’s physiology. There is concern, however, that arterial line insertion may increase time on scene and subsequently delay transport to definitive care. A focused, systematic review was undertaken to investigate this. A structured keyword search of MEDLINE and EMBASE identified four studies meeting the inclusion criteria. All four studies noted an association between arterial line insertion and increased scene time (4–34.4 min). The strength and interpretability of this evidence is limited. The clinical significance of this delay is unclear and is likely to be context specific.