Current practice in transferring critically ill patients among hospitals in the west of Scotland.

Reeve, William; Runcie, C. J.; Reidy, J.; Wallace, Peter G.

doi:10.1136/bmj.300.6717.85

Cited by 32 publications

(12 citation statements)

References 6 publications

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“…Various authors state that an important function of the retrieval physician is to reduce delay in instituting therapy 11,13 . The interventions performed by the retrieval physician in this series illustrates the usefulness of such a system for transporting critically ill patients.…”

Section: Discussionmentioning

confidence: 85%

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Clinical intervention in retrieval medicine

1997

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ObjectiveTo describe the clinical interventions undertaken by retrieval physicians during interhospital transfer between different hospital types and discuss the implications for staff training. MethodCase sheets from all interhospital transfers undertaken by the Sydney Aeromedical Retrieval Service for the 1995 calendar year were analysed retrospectively. Clinical interventions were categorised into airway management, invasive procedures, fluid resuscitation and drug therapy. Each category was then reviewed according to the functional level of the referring hospital. ResultsA total of 577 interhospital transfers occurred during this period. Two hundred and fifty eight (44.7%) patients transported required at least one clinical intervention. A total of 421 interventions were made. Of the 421 interventions performed 43% were classified as drug therapy, 34.4% as invasive procedures, 13.3% as fluid resuscitation and 9.3% as airway management. The overall intervention rate for those patients transported from tertiary hospitals was 0.31, for other metropolitan hospitals 0.78, for rural base hospitals 0.70 and for other rural hospitals 1.06. ConclusionThose physicians with advanced training in critical care medicine are most suited to the requirements of retrieval medicine. Patients from smaller hospitals have a greater likelihood of requiring intervention by the retrieval physician.

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Section: Discussionmentioning

confidence: 85%

“…The commitment to universal access to health care and the geography and demography of Australia make interhospital transfer an integral part of the present health care system. Many now consider it unacceptable to transfer critically ill patients without the use of an appropriate retrieval team 10–16 .…”

Section: Introductionmentioning

confidence: 99%

Clinical intervention in retrieval medicine

1997

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“…[9][10][11][17][18][19] Poor management during transfer between hospitals has been identified as an avoidable factor contributing to death of children with head injuries. 18 However, not all adverse events are preventable.…”

Section: Discussionmentioning

confidence: 99%

C Ost -B Enefit of T Rained T Ransport T Eams : E Stimates for H Ead-Injured C Hildren

Macnab¹,

Wensley²,

Sun³

2001

Prehospital Emergency Care

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During the first year o f the SciDAC gyrokinetic particle simulation (GPS) project, the GPS team (Zhihong Lin, Liu Chen, Yasutaro Nishimura, and Igor Holod) at the University of California, Irvine (UCI) studied the tokamak electron transport driven by electron temperature gradient (ETG) turbulence, and by trapped electron mode (TEM) turbulence and ion temperature gradient (ITG) turbulence with kinetic electron effects, extended our studies o f ITG turbulence spreading to core-edge coupling. We have developed and optimized an elliptic solver using finite element method (FEM), which enables the implementation of advanced kinetic electron models (split-weight scheme and hybrid model) in the SciDAC GPS production code GTC. The GTC code has been ported and optimized on both scalar and vector parallel computer architectures, and is being transformed into objected-oriented style to facilitate collaborative code development. During this period, the UCI team members presented 11 invited talks at major national and international conferences, published 22 papers in peer-reviewed journals and 10 papers in conference proceedings. The UCI hosted the annual SciDAC Workshop on Plasma Turbulence sponsored by the GPS Center, 2005-2007. The workshop was attended by about fifties US and foreign researchers and financially sponsored several gradual students from MIT, Princeton University, Germany, Switzerland, and Finland. A new SciDAC postdoc, Igor Holod, has arrived at UCI to initiate global particle simulation of magnetohydrodynamics turbulence driven by energetic particle modes. The PI, Z. Lin, has been promoted to the Associate Professor with tenure at UCI. Some highlights on the physics progress are listed below. I. Nonlinear physics of ETG turbulence Global gyrokinetic particle simulation and nonlinear gyrokinetic theory find that ETG instability saturates via nonlinear toroidal coupling, which is a nonlocal interaction, intrinsic to the toroidal geometries, in the wavevector space that transfers energy successively from unstable modes to damped modes preferentially with lower toroidal mode numbers. The electrostatic ETG turbulence is dominated by nonlinearly generated radial streamers. The length o f the streamers scales with the device size, which is longer than the distance between mode rational surfaces and electron radial excursions. Both fluctuation intensity' and transport level at saturation are independent of the streamer length, and are much smaller than mixing length estimates. These finds from global simulations are not consistent with previous flux-tube simulation results. II. ITG turbulence spreading Gyrokinetic particle simulations of toroidal ITG turbulence spreading3,4 and its related dynamical model have been extended to the case with radially increasing ion temperature gradient, to study the inward spreading of edge turbulence toward the core6. Due to turbulence spreading from the edge, the turbulence intensity in the core region is significantly enhanced over the value obtained from simulations o f the cor...

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“…Although a few excellent transport systems have been established, such as the Shock Team in Glasgow [5], there are no formal arrangements over most of the country. The overall need for interhospital transfer in the United Kingdom remains unknown, though for trauma-related transfers, accurate epidemiological data are now becoming available.…”

Section: How Often Is Interhospital Transfer Required?mentioning

confidence: 99%