Intra-hospital transport of critically ill patients: minimising risk

Shirley, Peter; Bion, Julian

doi:10.1007/s00134-004-2293-6

Cited by 48 publications

(45 citation statements)

References 9 publications

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“…It has been suggested that transports within the hospital occur much more often than those outside the hospital, and the in-hospital patients tend to be sicker than those transferred from other facilities. 44 Undoubtedly, the risk of transport must be weighed against the potential benefit for the patient. Waydhas's review found that diagnostic evaluations of patients changed management in 24 -70% of cases.…”

Section: Intra-hospital Transportmentioning

confidence: 99%

Inter- and Intra-hospital Transport of the Critically IllDiscussion

Blakeman

Branson

2013

Respir Care

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Intra-and inter-hospital transport is common due to the need for advanced diagnostics and procedures, and to provide access to specialized care. Risks are inherent during transport, so the anticipated benefits of transport must be weighed against the possible negative outcome during the transport. Adverse events are common in both in and out of hospital transports, the most common being equipment malfunctions. During inter-hospital transport, increased transfer time is associated with worse patient outcomes. The use of specialized teams with the transport of children has been shown to decrease adverse events. Intra-hospital transports often involve critically ill patients, which increases the likelihood of adverse events. Radiographic diagnostics are the most common in-hospital transport destination and the results often change the course of care. It is recommended that portable ventilators be used for transport, because studies show that use of a manual resuscitator alters blood gas values due to inconsistent ventilation. The performance of new generation transport ventilators has improved greatly and now allows for seamless transition from ICU ventilators. Diligent planning for and monitoring during transport may decrease adverse events and reduce risk.

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Section: Intra-hospital Transportmentioning

confidence: 99%

Inter- and Intra-hospital Transport of the Critically IllDiscussion

Blakeman

Branson

2013

Respir Care

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“…(1,2) The intrahospital transport is a period of instability and risk to patients, with the possibility of complications related to technical failures, physiological changes of patients, duration of transport, and with the team that performs it. (3)(4)(5) Furthermore, it must be taken into account that the sectors for which the patient is referred to not always have the same equipment that the intensive care unit. In this context, the indication, planning, implementation and stabilization after the procedure are of extreme importance in order to minimize complications and unnecessary risks to the patient.…”

Section: Introductionmentioning

confidence: 99%

Caracterização do transporte de pacientes críticos na modalidade intra-hospitalar

2014

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Objective: Characterizing the transport of critically ill patients in an adult intensive care unit. Methods: Cross-sectional study in which 459 intra -hospital transports of critically ill patients were included. Data were collected from clinical records of patients and from a form with the description of the materials and equipment necessary for the procedure, description of adverse events and of the transport team. Results: A total of 459 transports of 262 critically ill patients were carried out, with an average of 51 transports per month. Patients were on ventilatory support (41.3 %) and 34.5 % in use of vasoactive drugs. Adverse events occurred in 9.4% of transports and 77.3 % of the teams were composed of physicians, nurses and nurse technicians. Conclusion: The transport of critically ill patients occurred in the morning period for performing computerized tomographies (CT scans) with patients dependent on mechanical ventilation and vasoactive drugs. During the transports the equipment was functioning, and the adverse events were attributed to clinical changes of patients. ResumoObjetivo: Caracterizar o transporte de pacientes críticos em unidade de terapia intensiva adulto. Métodos: Estudo transversal onde foram incluídos 459 transportes de pacientes críticos na modalidade intrahospitalar. Os dados foram coletados nos prontuários clínicos dos pacientes e em um formulário com a descrição dos materiais e equipamentos necessários ao procedimento, descrição de ocorrências adversas e da equipe que realizou. Resultados: Foram realizados 459 transportes de 262 pacientes críticos com média de 51 transportes por mês. Eram pacientes em suporte ventilatório (41,3%) e 34,5% em uso de drogas vasoativas. Em 9,4% dos transportes ocorreram eventos adversos sendo 77,3% das equipes compostas por médico, enfermeiro e técnico de enfermagem. Conclusão: Os transportes de pacientes críticos ocorreram no período da manhã, para realização de tomografia computadorizada, com pacientes dependentes de suporte ventilatório e drogas vasoativas. Os equipamentos durante o transporte estavam funcionando e, os eventos adversos ocorridos foram atribuídos a alterações clínicas dos pacientes.

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“…Of the 12 articles reviewed, none were about intrafacility transports. 16 In their editorial published 10 years ago, however, Shirley and Bion 17 pointed out that transports within facilities occur more frequently and "since they reflect in microcosm the same challenges of inter-hospital land transfer, they deserve more attention. "…”

Section: Authorsmentioning

confidence: 99%

Safety First! Using a Checklist for Intrafacility Transport of Adult Intensive Care Patients

Comeau

Armendariz-Batiste

Woodby

2015

Critical Care Nurse

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Background Adult critical care patients in an academic medical center experienced adverse events during intrafacility transport resulting from lack of preparation. An intervention was needed to help keep patients safe during intrafacility transport. Objective To develop a checklist for transport that is easy to use and effective in preparing patients for transport. Method A checklist was developed and implemented. Elements of the checklist include preparation of the patient before transport, screening of patients for criteria that may place them at higher risk during transport, and a checklist for the procedural site. Results From May 2011 through July 2014, 2506 transports were conducted. Of these, 97.6% (n = 2445) involved no reported complications. Conclusion This tool is suitable for bedside clinicians to use when preparing patients for transport.

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Intra-hospital transport of critically ill patients: minimising risk

Cited by 48 publications

References 9 publications

Inter- and Intra-hospital Transport of the Critically IllDiscussion

Inter- and Intra-hospital Transport of the Critically IllDiscussion

Caracterização do transporte de pacientes críticos na modalidade intra-hospitalar

Safety First! Using a Checklist for Intrafacility Transport of Adult Intensive Care Patients

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