Critical events during intra-hospital transport of critically ill patients to and from intensive care unit
1Department of Anaesthesia and Intensive Care, Postgraduate Institute of Medical Education and Research, Chandigarh,
2Department of Trauma and Emergency (Anaesthesiology), All India Institute of Medical Sciences, Jodhpur, Rajasthan, India
Keywords: Critical events, intensive care unit, intrahospital transport
OBJECTIVES: Intensive care unit (ICU) patients are at an increased risk of many catastrophic events during intrahospital transport (IHT) for various procedures. This study was planned to determine the incidence and types of adverse events occurring during the transport of critically ill patients in a tertiary care hospital.
METHODS: This prospective observational study was conducted in the ICU of a tertiary care hospital for 8 months after ethical clearance from the institute ethics committee. All patients transported out of the ICU during the audit period for diagnostic or therapeutic procedures were included in the study. Vitals and several study parameters were recorded before, during, and after shifting patients to and from the ICU. Various critical events were noted during transport and classified into major and minor critical events based on the presence and absence of potential consequences that lead to a change of therapy during transport.
RESULTS: One hundred and sixty patients were studied for consecutive IHT to and from the ICU. The patients were transported for imaging studies (58.1%), minor surgery (31.8%), major surgery (2.5%), and other procedures (7.5%). A total of 248 critical events were observed in 104 IHTs (65%; 95% confidence interval [95% CI]: 57.4%–72.1%). Hence, an average of 2.38 critical events occurred per IHT. There were 31 major events among the 248 critical events (12.5%; 95% CI: 8.8%–17.1%).
CONCLUSIONS: Standard guidelines about the accompanying personnel and monitoring need to be followed during IHT. Conduct of minor surgical procedures in the ICU and better bedside diagnostic procedures may be considered for the future.
How to cite this article: Parveez MQ, Yaddanapudi LN, Saini V, Kajal K, Sharma A. Critical events during intra-hospital transport of critically ill patients to and from intensive care unit. Turk J Emerg Med 2020;20:135-41.
This prospective observational study was approved by the institutional ethics committee of the Postgraduate Institute of Medical Education and Research, India with the Ethical clearance letter no NK/ MD/1006/13492-93. Date: 2018.
MQP designed the study, acquired the data, analyzed the data, performed the statistics, and wrote the manuscript, LNY designed the study and supervised the analysis, KK supervised the design of the study, the data acquisition, and the analysis, VS analyzed the data and reviewed the manuscript, AS revised the manuscript and suggested changes and improvements.