Safety Hazards During Intrahospital Transport: A Prospective Observational Study

Bergman, Lina; Pettersson, Magnus; Chaboyer, Wendy; Carlström, Eric; Ringdal, Mona

doi:10.1097/ccm.0000000000002653

Cited by 68 publications

(74 citation statements)

References 48 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…In general, IHT is deemed hazardous in critically ill patients with common complications such as thrombosis, bleeding, or decline in pulmonary function (18). Bergman et al also reported technical hazards and equipment failure (19). Similar to our study, Martin et al focused on severe TBI patients.…”

Section: Discussionsupporting

confidence: 81%

Safety of Early MRI Examinations in Severe TBI: A Test Battery for Proper Patient Selection

et al. 2020

View full text Add to dashboard Cite

Introduction: Early magnetic resonance imaging (MRI) provides important information for management and prognosis in patients with severe traumatic brain injury (sTBI). Yet, optimal timing of MRI remains unknown. The aim of our study was to evaluate the safety of early MRI and to identify a method for appropriate patient selection to minimize adverse events related to the intrahospital transport (IHT) and the MRI examination. Methods: Twenty-six patients with sTBI [mean Glasgow Coma Scale (GCS) 6, range 3-8] admitted to our neurosurgical ICU from 03/2015 to 12/2017 and receiving at least one MRI within the first 14 days after initial traumatic event were prospectively included in the study. The following requirements were fulfilled for at least 4 h prior to anticipated MRI: MAP > 70 mmHg, aPCO 2 30-40 mmHg, stable ICP < 25 mmHg. All relevant cardiopulmonary and cerebral parameters and medication were recorded. The following MRI sequences were performed: DWI, FLAIR, 3D T2-space, 3D T1 MPRAGE, 3D SWI, 3D TOF, pASL, and 1 H/ 31 P-MRS. Results: Four females and 22 males (aged 23-78 years, mean 46.4 years) with a median GCS on admission of 5 (range 3-8) were analyzed. In total, 40 IHTs were performed within the first 14 days (mean 6 days, range 1-14 days). Mean pre-MRI ICP was 14.1 mmHg (range 3-32 mmHg). The mean post-MRI ICP was 14.3 mmHg (range 3-29 mmHg), decreasing to a mean ICP of 13.2 mmHg after 1 h (range 3-29 mmHg). There were no significant differences in ICP measurements before and after MRI (p = 0.30). MAP remained stable with no significant changes during the entire IHT and MRI. No other adverse events were observed as well. Conclusion: Early MRI in acute severe TBI is feasible and safe. Yet, careful patient selection with prior adequate testing of cardiopulmonary and cerebral parameters is crucial to minimize transport-or examination-related morbidity.

show abstract

Section: Discussionsupporting

confidence: 81%

Safety of Early MRI Examinations in Severe TBI: A Test Battery for Proper Patient Selection

et al. 2020

View full text Add to dashboard Cite

show abstract

“…In recent years, the interest in studying different types of transfers in intensive care has increased (Bergman, Pettersson, Chaboyer, Carlstrom, & Ringdal, 2017;Eiding, Kongsgaard, & Braarud, 2019;Herling et al, 2020). Despite this development, interhospital intensive care unit-to-unit transfers from the family members' perspective have been sparsely investigated (Burns & Petrucka, 2020).…”

Section: Backg Rou N Dmentioning

confidence: 99%

Family members' lived experiences when a loved one undergoes an interhospital intensive care unit‐to‐unit transfer: A phenomenological hermeneutical study

Karlsson

Eriksson

Lindahl

et al. 2020

Journal of Clinical Nursing

View full text Add to dashboard Cite

Aims and objectives To reveal meanings of family members' lived experiences when a loved one undergoes an interhospital intensive care unit‐to‐unit transfer. Background Interhospital intensive care unit‐to‐unit transfers take place between different hospitals and their respective intensive care units (ICUs). These types of transfers are an increasing phenomenon but are sparsely studied from the family members' perspective. Indeed, the patient's critical illness and care can have a major impact on family members. During the transfer process, there is a demand for the involved intensive care health personnel to make family members feel safe and cared for. Design A qualitative design based on phenomenological hermeneutics. Methods The study was conducted at two Swedish general ICUs. Data were generated through individual in‐depth interviews with seven family members and analysed using a phenomenological hermeneutical approach. The Criteria for Reporting Qualitative Research principles were applied in the conduct and reporting of this study. Results Four themes that reveal meanings of family members' lived experiences were developed: losing your safe haven, dealing with uncertainty, carrying your own and others' burdens and a wish to be close. Conclusions The study reveals that an interhospital intensive care unit‐to‐unit transfer affects the whole family and is characterised by family members experiencing many negative feelings. The findings also illustrate that being a family member when a loved one is transferred means being exposed to the core existential elements of being human, such as loneliness and searching for meaning. Relevance to clinical practice The study highlights the importance of maintaining a family‐centred approach during the transfer process. Our findings can provide deeper knowledge for intensive care health personnel, better preparing them for the delicate task of providing family‐centred care during the interhospital intensive care unit‐to‐unit transfer process.

show abstract

“…We also postponed performing a CT scan of the chest as we judged patient transport to be too dangerous given the patient's clinical instability. 17 We did not expect these results to change medical management or patient outcome. The CT scan performed later on hospital day 34 showed ground-glass infiltrates, similar to those described by Miller et al At the time of this publication, there is no known treatment specifically targeting patients with ARDS associated with TMP-SMX.…”

Section: Discussionmentioning

confidence: 97%

Suspected Case of Drug-Induced Acute Respiratory Distress Syndrome following Trimethoprim-Sulfamethoxazole Treatment

Natterer

Rizzati

Perez

et al. 2020

J Pediatr Intensive Care

View full text Add to dashboard Cite

We report the case of a child who was admitted to our PICU for severe acute respiratory distress syndrome (ARDS) while being treated with trimethoprim-sulfamethoxazole (TMP-SMX) for osteomyelitis. Based on the timing of exposure, lack of alternative explanations, and clinical course similar to previously described cases, we suspect that TMP-SMX may have triggered ARDS. Despite meeting criteria for extracorporeal membrane oxygenation cannulation, conservative management and lung recruitment with high-frequency percussive ventilation could avoid the latter.

show abstract

Safety Hazards During Intrahospital Transport: A Prospective Observational Study

Abstract: Findings suggest that intrahospital transport is a hazardous process for critically ill patients. We have identified several factors that may contribute to transport-related adverse events, which will provide the opportunity for the redesign of systems to enhance patient safety.

Cited by 68 publications

References 48 publications

Safety of Early MRI Examinations in Severe TBI: A Test Battery for Proper Patient Selection

Safety of Early MRI Examinations in Severe TBI: A Test Battery for Proper Patient Selection

Family members' lived experiences when a loved one undergoes an interhospital intensive care unit‐to‐unit transfer: A phenomenological hermeneutical study

Suspected Case of Drug-Induced Acute Respiratory Distress Syndrome following Trimethoprim-Sulfamethoxazole Treatment

Contact Info

Product

Resources

About