Mishaps during transport from the intensive care unit

Smith, Ira; Fleming, S.; Cernaianu, Aurel C.

doi:10.1097/00003246-199003000-00006

Cited by 235 publications

(103 citation statements)

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“…We identified that malfunction of an aircraft or its associated aviation equipment occurred in 143 flights. Events due to malfunction of medical equipment occur in patient transfer, 43–45 and data from this study are comparable. Our organization is collaborating with human factors experts to determine what role equipment and aircraft interior design may have on this event category.…”

Section: Discussionsupporting

confidence: 55%

Epidemiology of Adverse Events in Air Medical Transport

MacDonald

Banks

Morrison

2008

Academic Emergency Medicine

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Objectives: This observational study determined frequency and describes all-cause adverse event epidemiology in a large air medical transport system.Methods: Records of a mandatory reporting system were reviewed and a data set containing all of the patient care records was searched to identify aviation-and non-aviation-related adverse events. Two reviewers independently identified adverse events and categorized them using an established taxonomy. Descriptive statistics were used to report adverse events, with frequency calculated per 1,000 flights and 1,000 hours flown.Results: Between January 1, 2002, and June 30, 2005, there were 1,447 reports, of which 598 included an adverse event. Case-finding identified an additional 125. A complete report was available in 680 of 723 (94.1%) events. There were 58,956 flights and 103,632 hours flown during the study period, for a rate of 11.53 adverse events per 1,000 flights (95% CI = 10.7 to 12.4 adverse events) or 6.56 per 1,000 hours flown (95% CI = 6.1 to 7.1 adverse events). The frequencies of events by category were as follows: communication (229; 33.7%), transport vehicle (143; 21.0%), medical equipment (88; 12.9%), patient management (77; 11.4%), clinical performance (68; 10.0%), weather (30; 4.4%), unclassified (24; 3.5%), and patient factors causing death (21; 3.1%). There was possible patient harm in 117 events.Conclusions: Air medical transport is associated with a low incidence of adverse events and possible patient harm. Communication problems were the most common cause of an event. Determining event epidemiology is necessary to identify modifiable factors, propose solutions to decrease the adverse events, and direct future efforts to improve safety.ACADEMIC EMERGENCY MEDICINE 2008; 15:923-931 ª

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Section: Discussionsupporting

confidence: 55%

Epidemiology of Adverse Events in Air Medical Transport

MacDonald

Banks

Morrison

2008

Academic Emergency Medicine

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“…They should be avoided by proper preparation and checks before IHT. Good coordination between the radiology team and the ICU is essential, because duration of transport also is associated with patient-related AE, a point already shown in other studies, such as those by Lahner or Smith [9,26]. …”

Section: Discussionmentioning

confidence: 96%

Adverse events during intrahospital transport of critically ill patients: incidence and risk factors

et al. 2013

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BackgroundTransport of critically ill patients for diagnostic or therapeutic procedures is at risk of complications. Adverse events during transport are common and may have significant consequences for the patient. The objective of the study was to collect prospectively adverse events that occurred during intrahospital transports of critically ill patients and to determine their risk factors.MethodsThis prospective, observational study of intrahospital transport of consecutively admitted patients with mechanical ventilation was conducted in a 38-bed intensive care unit in a university hospital from May 2009 to March 2010.ResultsOf 262 transports observed (184 patients), 120 (45.8%) were associated with adverse events. Risk factors were ventilation with positive end-expiratory pressure >6 cmH2O, sedation before transport, and fluid loading for intrahospital transports. Within these intrahospital transports with adverse events, 68 (26% of all intrahospital transports) were associated with an adverse event affecting the patient. Identified risk factors were: positive end-expiratory pressure >6 cmH2O, and treatment modification before transport. In 44 cases (16.8% of all intrahospital transports), adverse event was considered serious for the patient. In our study, adverse events did not statistically increase ventilator-associated pneumonia, time spent on mechanical ventilation, or length of stay in the intensive care unit.ConclusionsThis study confirms that the intrahospital transports of critically ill patients leads to a significant number of adverse events. Although in our study adverse events have not had major consequences on the patient stay, efforts should be made to decrease their incidence.

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“…It is clear that critically ill patients needing to be prepared for transport are at high risk of physiological decline due to equipment (technical factors) and/or clinical status (patient factor), not to mention the collective and human factors that can also intervene [27]. …”

Section: Discussionmentioning

confidence: 99%

“…Over the last 20 years, several authors have investigated the complications involved in IHT [27,30], and have concluded that IHT should be considered as a type of secondary inter-hospital transfer so that management of critically-ill patients is conducted in the same way [31-33]. According to a recent review in the literature on the inter-hospital transport of critically-ill patients, the number of AEs is negligible, and no incidence rate has been established [34].…”

Section: Discussionmentioning

confidence: 99%

Recommendations for the intra-hospital transport of critically ill patients

Fanara¹,

Manzon²,

Barbot³

et al. 2010

Crit Care

241

208

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IntroductionThis study was conducted to provide Intensive Care Units and Emergency Departments with a set of practical procedures (check-lists) for managing critically-ill adult patients in order to avoid complications during intra-hospital transport (IHT).MethodsDigital research was carried out via the MEDLINE, EMBASE, CINAHL and HEALTHSTAR databases using the following key words: transferring, transport, intrahospital or intra-hospital, and critically ill patient. The reference bibliographies of each of the selected articles between 1998 and 2009 were also studied.ResultsThis review focuses on the analysis and overcoming of IHT-related risks, the associated adverse events, and their nature and incidence. The suggested preventive measures are also reviewed. A check-list for quick execution of IHT is then put forward and justified.ConclusionsDespite improvements in IHT practices, significant risks are still involved. Basic training, good clinical sense and a risk-benefit analysis are currently the only deciding factors. A critically ill patient, prepared and accompanied by an inexperienced team, is a risky combination. The development of adapted equipment and the widespread use of check-lists and proper training programmes would increase the safety of IHT and reduce the risks in the long-term. Further investigation is required in order to evaluate the protective role of such preventive measures.

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Mishaps during transport from the intensive care unit

Cited by 235 publications

References 0 publications

Epidemiology of Adverse Events in Air Medical Transport

Epidemiology of Adverse Events in Air Medical Transport

Adverse events during intrahospital transport of critically ill patients: incidence and risk factors

Recommendations for the intra-hospital transport of critically ill patients

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