Mobile intensive care services in rural South Australia

Abstract

Synopsis In the years from to 1995, Adelaide‐based mobile intensive care teams transported 4443 critically ill patients from rural areas in South Australia and adjacent States to tertiary‐level hospitals in Adelaide. The SA Ambulance Service undertook communications, support staffing and deployment of transport. Average radial distances in 819 road missions were 71 km, in 808 helicopter missions 122 km, and in 2777 fixed‐wing aircraft missions 398 km. The largest groups of patients were neonates (23%) and those with trauma (25%). Rural hospitals made 96% of the requests for intensive care transport; 4% came from ambulance or other emergency service crews at accident locations. Emergency surgical or operative obstetrical procedures were performed on 2.7% of patients before transport. One hundred and thirteen patients (2.5%) died during resuscitation or transport, with one death deemed to be preventable.

Pre- and Inter-Hospital Transport of Severely Head-Injured Patients in Rural Northern Norway

“…The principal finding of this study is that most patients with severe traumatic brain injury in Northern Norway undergo air transport and that via this approach it is possible to achieve short inter-hospital transfer times despite extremely long geographical distances. This is in accordance with experience from other rural regions of the world (Rogers et al, 1999;Gilligan et al, 1999).…”

Aeromedical Retrieval for Critical Clinical Conditions: 12 Years of Experience with the Royal Flying Doctor Service, Queensland, Australia

“…This study found that the death rate in transport for critically ill patients was 1%, compared to 2.5% in South Australia, and 4% in the UK and Canada (33)(34)(35). This low rate may be a direct reflection of the quality of in-transit care provided as described above, notwithstanding the selfselection bias inherent in any service that has prolonged response times due to the geography and logistics surrounding the extensive distances involved and the use of fixedwing aircraft, which require linking road transport.…”

How Do I Transport the Critically Ill Patient?

“…2,15,[29][30][31][32][33] Even with specialist mobile intensive care teams, mortality before and during transport is substantial (2.5%) despite a low incidence of preventable deaths during transport (0.02% to 0.04%). 2,15,[29][30][31][32][33] Even with specialist mobile intensive care teams, mortality before and during transport is substantial (2.5%) despite a low incidence of preventable deaths during transport (0.02% to 0.04%).…”