Intra-hospital Transport of Brain-Injured Patients: A Prospective, Observational Study

Abstract

Intra-hospital transport of brain-injured NICU patients may present some hazards even if performed by skilled personnel with specialized equipment. In Trauma Centers such as ours, an improvement in the frequency of neuromonitoring [intra-cranial pressure (ICP) and end-tidal CO2 (ET(CO(2)))] during transport is recommended.

Intrahospital transport of mechanically ventilated intensive care patients using new equipment attached to a transfer board

“…Intrahospital transport has been a significant risk factor for ventilator‐associated pneumonia because of endotracheal tube displacement and is associated with significant worsening of oxygenation . There were no significant changes in physiological state in this study.…”

Safety First! Using a Checklist for Intrafacility Transport of Adult Intensive Care Patients

“…5,7,11,19,21,23,[26][27][28][29]39 Lahner et al 25 reports that anesthesiologists perform all transports; nurses do not routinely accompany patients during transport. Winter 40 recommends that an intrafacility transport be delayed until an adequately trained physician is present.…”

“…Many authors caution readers that a risk-to-benefit evaluation should be made by the treatment team before the decision is made to transport a patient in order to ensure that the need for transport justifies the risk of moving the patient. 4,6,7,14,15,[18][19][20] In one study 21 of neurologically injured patients, only 5.5% of computed tomography (CT) scans led to a new surgical decision. It is important to note, however, that not obtaining a CT scan may have serious consequences.…”

Detection of Cerebral Vasospasm Following Aneurysmal Subarachnoid Hemorrhage Using Motor Evoked Potentials

“…As with nearly all imaging methods, CTA and PCT require the patient to be transferred to the imaging unit, which is costly and has been shown to put patients at increased medical risk. 31 Because of these limitations and the exposure of patients to radiation, CTA and PCT are unlikely to be used daily, therefore, increasing the chance that VS is missed or detected too late to prevent delayed ischemic neurological deficit. DSA is considered the gold standard for VS detection because of its ability to demonstrate cerebral VS anatomically with high accuracy and because it offers the opportunity to perform balloon angioplasty and chemical spasmolysis immediately.…”