Indian Journal of Critical Care Medicine

Register      Login

SEARCH WITHIN CONTENT

FIND ARTICLE

Volume / Issue

Online First

Archive
Related articles

VOLUME 18 , ISSUE 6 ( June, 2014 ) > List of Articles

RESEARCH ARTICLE

Unexpected events occurring during the intra-hospital transport of critically ill ICU patients

Dnyaneshwar P. Mutkule, Pradeep M. Venkategowda, Alai N. Taggu

Keywords : Adverse events, intra-hospital transport, intensivist, unexpected events

Citation Information : Mutkule DP, Venkategowda PM, Taggu AN. Unexpected events occurring during the intra-hospital transport of critically ill ICU patients. Indian J Crit Care Med 2014; 18 (6):354-357.

DOI: 10.4103/0972-5229.133880

License: CC BY-ND 3.0

Published Online: 01-01-2006

Copyright Statement:  Copyright © 2014; The Author(s).


Abstract

Background: Intra-hospital transport of critically ill patients is a challenging task. However, despite the improvements in intra-hospital transport practices, adverse event incidents remain high and constitute a significant risk for the transport of the critically ill ICU patients. Objectives: To observe the number and types of unexpected-events (UEs) occurring during intra-hospital transport of critically ill ICU patients. Interventions provided along with outcome. Materials and Methods: This was a prospective observational study of 254 intra-hospital critically-ill ICU patients of our hospital transported for diagnostic purposes during April 2012 - March 2013. The escorting intensivist completed the data of unexpected events during transport. Results: A total of 254 patients were observed prospectively for UEs during intra-hospital transfer of critically ill patients. The overall UEs observed were 139 among 64 patients. Among the UEs which occurred, the maximum were miscellaneous causes [89 (64.00%)] like oxygen probe [38 (27.33%)] or ECG lead displacement [27 (19.42%)]. Major events like fall in spo2 >5% observed in 15 (10.79%) patients, BP variation > 20% from baseline in 22 (15.82%) patients, altered mental status in 5 (3.59%), and arrhythmias in 6 (4.31%) patients. Among 64 (100%) patients with UEs, 3 (2.15%) patients with serious adverse events have been aborted from transport. Conclusion: Unexpected-events (UEs) are common during transport of critically ill ICU patients and these adverse events can be reduced when critically ill patients are accompanied by intensivist/medically qualified person during transport and following strict transport guidelines.


PDF Share
  1. Venkataraman ST, Orr RA. Intra hospital transport of critically ill patients. Crit Care Clin 1992;8:525-31.
  2. Link J, Krause H, Wagner W, Papadopoulos G. Intra hospital transport of critically ill patients. Crit Care Med 1990;18:1427-9.
  3. Caruana M, Culp K. Intra hospital transport of the critically ill adult: A research review and implications. Dimens Crit Care Nurs 1998;17:146-56.
  4. Fromm RE Jr, Dellinger RP. Transport of critically ill patients. J Intensive Care Med 1992;7:223-33.
  5. Warren J, Fromm RE Jr, Orr RA, Rotello LC, Horst MH; Ameriacan College of Critical Care Medicine. Guidelines for the inter and intra hospital transport of critically ill patients. Crit Care Med 2004;32:256-62.
  6. Isccm.org [Internet]. India: Guidelines for transport of critically ill patients in Indian Intensive care units. Section 4. Available from: http://www.isccm.org/. 5/29/2007.
  7. Waydhas C. Intra hospital transport of critically ill patients. Crit Care Med 1999;3:83-9.
  8. Shirley PJ, Bion JF. Intra-hospital transport of critically ill patients: Minimizing risk. Intensive Care Med 2004;30:1508-10.
  9. Beckmann U, Gillies DM, Berenholtz SM, Wu AW, Pronovost P. Incidents relating to the intra hospital transfer of critically ill patients: An analysis of the reports submitted to the Australian incident monitoring study in intensive care. Intensive Care Med 2004;30:1579-85.
  10. Lahner D, Nikolic A, Marhofer P, Koinig H, Germann P, Weinstabl C, et al. Incidence of complications in intra hospital transport of critically ill patients experience in an Austrian university hospital. Wien Klin Wochenschr 2007;119:412-6.
  11. Papson JP, Russell KL, Taylor DM. Unexpected events during the intra hospital transport of critically ill patients. Acad Emerg Med 2007;14:574-7.
  12. Australasian College for Emergency Medicine, Australian and New Zealand College of Anaesthetists. Joint Faculty of Intensive Care Medicine. Minimum standards for intra hospital transport of critically ill patients. Emerg Med 2003;15:202-4.
  13. Gillman L, Leslie G, Williams T, Fawcett K, Bell R, McGibbon V. Adverse events experienced while transferring the critically ill patient from the emergency department to the intensive care unit. Emerg Med J 2006;23:858-61.
  14. Stevenson VW, Haas CF, Wahl WL. Intra hospital transport of the adult mechanically ventilated patient. Respir Care Clin N Am 2002;8:1-35.
  15. Tice P. Intra hospital transport of critically ill adults: Potential physiologic changes and nursing implications. Focus Crit Care 1991;18:424-8.
  16. Wallen E, Venkataraman ST, Grosso MJ, Kiene K, Orr RA. Intra hospital transport of critically ill pediatric patients. Crit Care Med 1995;23:1588-95.
  17. Smith I, Fleming S, Cernaianu A. Mishaps during transport from the intensive care unit. Crit Care Med 1990;18:278-81.
  18. Szem JW, Hydo LJ, Fischer E, Kapur S, Klemperer J, Barie PS. High-risk intra hospital transport of critically ill patients safety and outcome of the necessary road trip. Crit Care Med 1995;23:1660-6.
  19. Stearley HE. Patients outcomes: Intra hospital transportation and monitoring of critically ill patients by a specially trained ICU nursing staff. Am J Crit Care 1998;7:282-7.
  20. Evans A, Winslow EH. Oxygen saturation and hemodynamic response in critically ill mechanically ventilated adults during intra hospital transport. Am J Crit Care 1995;4:106-11.
  21. Taylor JO, Landers CF, Chulay, Hood W Jr, Abelman WH. Monitoring high-risk cardiac patients during transportation in hospital. Lancet 1970;2:1205-8.
  22. Insel J, Weissman C, Kemper M, Askanazi J, Hyman AI. Cardiovascular changes during transport of critically ill and postoperative patients. Crit Care Med 1986;14:539-42.
  23. Andrews PJ, Piper IR, Dearden NM, Miller JD. Secondary insults during intra hospital transport of head injured patients. Lancet 1990;335:327-30.
  24. Indeck M, Peterson S, Smith J, Brotman S. Risk cost and benefit of transporting ICU patients for special studies. J Trauma 1988;28:1020-5.
  25. Hurst JM, Davis K Jr, Johnson DJ, Branson RD, Campbell RS, Branson PS. Cost and complications during in-hospital transport of critically ill patients: A prospective cohort study. J Trauma 1992;33:582-5.
  26. Weg JG, Haas CF. Safe intra hospital transport of critically ill ventilator dependent patients. Chest 1989; 96:631-5.
  27. Braman SS, Dunn SM, Amico A, Millman RP. Complications of intra hospital transport in critically ill patients. Ann Intern Med 1987;107:469-73.
PDF Share
PDF Share

© Jaypee Brothers Medical Publishers (P) LTD.