Recommendations for the intra-hospital transport of critically ill patients

Abstract

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.

Should a Portable Ventilator Be Used in All In-Hospital Transports?

“…22 During transport, hypoxia-related adverse events have been associated with inadequate oxygen reserves, atelectasis, and patient agitation. 4 Needless to say, oxygenation must be closely monitored during transport, and equipment must be used that can deliver high oxygen concentrations and adequate amounts of PEEP when clinically indicated.…”

“…1,2 Established recommendations to minimize the potential for adverse events include careful planning before transport as well as ensuring that the following are available: a monitor with defibrillator; resuscitation equipment and drugs; sufficient supplies of oxygen and batteries; a manual resuscitator with mask; a transport ventilator; and, most importantly, skilled personnel. 3,4 Pro: A Portable Ventilator Should Be Used in All…”

Saugesnio Ir Veiksmingesnio Pacientų Tarpstacionarinio Transportavimo Principai

“…Tarpstacionarinis transportavimas (TT) daugeliui pacientų tapo kasdienine ir neatsiejama sveikatos priežiūros paslaugų dalimi ne tik dėl didesnių galimybių gauti specializuotą gydymą ar diagnostines procedūras aukštesnio ar aukščiausio lygio sveikatos priežiūros paslaugas teikiančiose gydymo įstaigose, bet ir baigti gydymą arčiau namų esančiose asmens sveikatos priežiūros įstaigose [1]. Pacientų transportavimas laikomas viena iš pagrindinių veiklų, turinčių didelę įtaką sveikatos priežiūroje [2].…”

Intra-Hospital Transport of Patients on Non-Invasive Ventilation: Review, Analysis, and Key Practical Recommendations by the International NIV Committee

“…This means that patients may be transferred to different sections of the hospital without changing the modality and parameters of their ventilatory support. It is notable that while unexpected events during the intra-hospital transfer of critical patients receiving conventional ventilation have been extensively reviewed (4,(12)(13)(14)(15), few recommendations regarding patients receiving NIV support are available.…”