Interhospital Transfer of Critically Ill COVID-19 Patients: Preliminary Considerations From the Emilia-Romagna Experience

Mazzoli, Carlo Alberto; Gamberini, Lorenzo; Lupi, Cristian; Tartaglione, Marco; Coniglio, Carlo; Franceschini, A.; Barbalace, Clara; Gordini, Giovanni; Chiarini, Valentina

doi:10.1016/j.amj.2020.05.014

Cited by 6 publications

(12 citation statements)

References 11 publications

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“…Patient characteristics were consistent with those reported in the literature for patients with COVID-19 requiring invasive mechanical ventilation. 10 11 Although a few authors have proposed recommendations for the medicalised transfer of patients with COVID-19 [12][13][14][15] and few studies have described the transfer procedures. 6 16 In our study, the characteristics of the patients were consistent with those reported in the handful of previous studies of medical evacuations.…”

Section: Discussionmentioning

confidence: 99%

Collective aeromedical evacuations of SARS-CoV-2-related ARDS patients in a military tactical plane: a retrospective descriptive study

et al. 2021

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After the appearance of the COVID-19 pandemic in France, MEROPE system was created to transform the military tactical ATLAS A400M aircraft into a flying intensive care unit. Collective aeromedical evacuations (aero-MEDEVAC) of patients suffering from SARS-CoV-2-related acute respiratory distress syndrome was performed from June to December 2020. A total of 22 patients were transported during seven missions. All aero-MEDEVAC was performed in safe conditions for patients and crew. No life-threatening conditions occurred during flight. Biohazard controls were applied according to French guidelines and prevented crew contamination. Thanks to rigorous selection criteria and continuous in-flight medical care, the safe transportation of these patients was possible. To the best of our knowledge, this is the first description of collective aero-MEDEVAC of these kinds of patients using a tactical military aircraft. We here describe the patient’s characteristics and the flight’s challenges.

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Section: Discussionmentioning

confidence: 99%

Collective aeromedical evacuations of SARS-CoV-2-related ARDS patients in a military tactical plane: a retrospective descriptive study

et al. 2021

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“…From the beginning of COVID-19 outbreak and the implementation of the quarantine, the number of overall HEMS missions (usually 800 per year) decreased by 80%, mainly because of the reduction of road and work-related accidents. This allowed the use of HEMS for the organisation of secondary transfers of patients with COVID-19 from the overwhelmed hospitals in the western provinces of Emilia-Romagna 5 (see figure 1). HEMS was mainly used to carry the medical teams dedicated to the transfer of patients with COVID-19 to the sending hospital while the transfer to the receiving hospital was via ground ambulances in order to avoid the need for helicopter decontamination at the end of the mission.…”

Section: Helicopter Emergency Medical Systemmentioning

confidence: 99%

Remodelling of a regional emergency hub in response to the COVID-19 outbreak in Emilia-Romagna

et al. 2021

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Emilia-Romagna was one of the most affected Italian regions during the COVID-19 outbreak in February 2020. We describe here the profound regional, provincial and municipal changes in response to the COVID-19 pandemic, to cope with the numbers of patients presenting with COVID-19 illness, as well as coping with the ongoing need to care for patients presenting with non-COVID-19 emergencies. We focus on the structural and functional changes in one particular hospital within the city of Bologna, the regional capital, which acted as the central emergency hub for time-sensitive pathologies for the province of Bologna. Finally, we present the admissions profile to our emergency department in relation to the massive increase of infected patients observed in our region as well as the organisational response to prepare for the second wave of the pandemic.

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“…It is common for the patients to experience adverse events during transport, even the shortest transport may cause life-threatening conditions [ 7 , 9 – 11 ]. Patient transport can lead to various adverse events such as severe hypotension, decreasing level of consciousness, oxygen desaturation, accidental extubation, poorly or incorrectly placed endotracheal tube, procedural errors, neurological deterioration, medication errors, accidental physical injuries, longer hospital, and intensive care unit (ICU) stay, and death [ 7 , 10 , 12 – 14 ].…”

Section: Introductionmentioning

confidence: 99%

“…Evidence has shown that the fundamental principle of guaranteeing the best available standard emergency care to COVID-19 patients could be challenging during the transport of the patient between facilities [ 12 ]. The factors that compromise professionals’ and patient’s safety during the transport of highly communicable diseases, including COVID-19, are multifaceted.…”

Section: Introductionmentioning

confidence: 99%

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The status of prehospital care delivery for COVID-19 patients in Addis Ababa, Ethiopia: The study emphasizing adverse events occurring in prehospital transport and associated factors

2022

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Background COVID-19 patients may require emergency medical services for emergent treatment and/or transport to a hospital for further treatment. However, it is common for the patients to experience adverse events during transport, even the shortest transport may cause life-threatening conditions. Most of the studies that have been done on prehospital care of COVID-19 patients were conducted in developed countries. Differences in population demographics and economy may limit the generalizability of available studies. So, this study was aimed at investigating the status of prehospital care delivery for COVID-19 patients in Addis Ababa focusing on adverse events that occurred during transport and associated factors. Methods A total of 233 patients consecutively transported to Saint Paul’s Hospital Millennium Medical College from November 6 to December 31, 2020, were included in the study. A team of physicians and nurses collected the data using a structured questionnaire. Descriptive statistics were used to summarize data, and ordinal logistic regression was carried out to assess the association between explanatory variables and the outcome variable. Results are presented using frequency, percentage, chi-square, crude and adjusted odds ratios (OR) with 95% confidence intervals. Results The overall level of adverse events in prehospital setting was 44.2%. Having history of at least one chronic medical illness, [AOR3.2 (95%; CI; 1.11–9.53)]; distance traveled to reach destination facility, [AOR 0.11(95%; CI; 0.02–0.54)]; failure to recognize and administer oxygen to the patient in need of oxygen, [AOR 15.0(95%; CI; 4.0–55.7)]; absent or malfunctioned suctioning device, [AOR 4.0(95%; CI; 1.2–13.0)]; patients handling mishaps, [AOR 12.7(95%; CI; 2.9–56.8)] were the factors associated with adverse events in prehospital transport of COVID-19 patients. Conclusions There were a significant proportion of adverse events in prehospital care among COVID-19 patients. Most of the adverse events were preventable. There is an urgent need to strengthen prehospital emergency care in Ethiopia by equipping the ambulances with essential and properly functioning equipment and trained manpower. Awareness creation and training of transport staff in identifying potential hazards, at-risk patients, adequate documentation, and patient handling during transport could help to prevent or minimize adverse events in prehospital care.

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Interhospital Transfer of Critically Ill COVID-19 Patients: Preliminary Considerations From the Emilia-Romagna Experience

Cited by 6 publications

References 11 publications

Collective aeromedical evacuations of SARS-CoV-2-related ARDS patients in a military tactical plane: a retrospective descriptive study

Collective aeromedical evacuations of SARS-CoV-2-related ARDS patients in a military tactical plane: a retrospective descriptive study

Remodelling of a regional emergency hub in response to the COVID-19 outbreak in Emilia-Romagna

The status of prehospital care delivery for COVID-19 patients in Addis Ababa, Ethiopia: The study emphasizing adverse events occurring in prehospital transport and associated factors

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