Inter- and Intra-hospital Transport of the Critically IllDiscussion

Abstract

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.

Five-year experience with mobile adult extracorporeal membrane oxygenation in a tertiary referral center

“…In addition to the standard risks involved in the transport of the critically ill patient, the out of hospital nature of this transport adds more significance to the risk of essential equipment failure [9,10), and therefore more risk to the patient. In order to reduce this risk, set transport protocols should be adhered to [10,14,15]. This includes having well trained and experienced staff, appropriate equipment and monitoring for transfer and checklists.…”

Modeling and optimization of resources in multi-emergency department settings with patient transfer

“…Depending upon the decision of each hospital, transferring patients can be applied to any group of low, medium or high-acuity patients. One of the main concerns about this strategy is long travel time between hospitals and associated risks for emergency patients, which causes doubt about the effectiveness of this method for emergency cases [40]. A summary of the key articles discussed in the literature review is provided in Table 1.…”

Saugesnio Ir Veiksmingesnio Pacientų Tarpstacionarinio Transportavimo Principai

“…Paskutiniame dešimtmetyje didelis dėmesys buvo skiriamas antriniam pacientų transportavimui [1,6,[15][16][17]. Tačiau didžiąją transportuojamų pacientų dalį sudaro nekritinės būklės ligoniai, reikalaujantys tretinio TT, kuris, pasak mokslinių tyrimų, reikšmingai didėja [18][19][20].…”