Unexpected Events during the Intrahospital Transport of Critically Ill Patients

Abstract

Unexpected events during the intrahospital transport of critically ill patients from the emergency department are common and can be potentially life threatening. Transporting physician experience is associated with UE rate. Strict adherence to and review of existing transport guidelines is recommended.

A Portable CT Scanner in the Pediatric Intensive Care Unit Decreases Transfer-Associated Adverse Events and Staff Disruption

“…Over 70% of intrahospital transfers are reported as being associated with unexpected events, either equipment-or patient-related [6,7], and our findings (75%) are certainly agreeable with this. Children requiring neurocritical care are at particular higher risks with transfer, as urgent head scans are performed during periods of severe physiological instability, to diagnose or rule out a severe complication such as expanding intracranial hematoma or acute hydrocephalus [8,9].…”

Intrahospital transport of critically ill patients

“…Die meisten Zwischenfälle während eines Transports erfordern eine Intervention durch das begleitende Personal [23]. Die Entscheidungsfindung zur Problemlösung erfolgt in diesen Fällen unter Zeitdruck und in einer ungewohnten Umgebung (Krankenhausflur, Fahrstuhl).…”

Nurse Knowledge of Intrahospital Transport

“…In 2007, equipment and patient instability were identified as issues contributing to adverse events, whereas training and education were recommended to improve adherence with guidelines. 4 Adverse events may occur in up to 68% of all IHT, with 4.2% to 8.9% requiring therapeutic interventions. 5 To transport critically ill patients in a safe and effective manner, a large magnet hospital in the Southeastern United States developed a specific IHT policy and a clinical handover policy, including specific definitions and procedures.…”

“…Guidelines for IHT are well defined and uniform and consistently involve preplanning, adequate and experienced staff, acceptable equipment, continuation of the level of monitoring in the ICU, and communication. [2][3][4][5]18 Patient risk factors are well defined and include physiologic instability, mechanical ventilation, and long transports. Recommendations for improving patient safety during IHT consistently include equipment management, team composition, and enhanced communication through education and training.…”

“…[2][3][4][5]8 Despite safety initiatives, adverse events continue to occur and can include hypoxemia, hypothermia, arrhythmia, hypotension, hypertension, pneumothorax, intracranial hypertension, accidental extubation/loss of airway, bronchospasm, equipment failure, wrong patient transports, cardiac arrest, and death. 5 At the hospital that provided the setting for this project, IHT affects 12% of trauma patients undergoing surgery.…”