Waddell G
Br Med J. 1975 May 24;2(5968):417-9. doi: 10.1136/bmj.2.5968.417.
Critically ill patients were observed during routine movement inside the hospital to and from the intensive therapy unit. One patient a month suffered major cardiorespiratory collapse or death as a direct result of movement. Renewed bleeding of a pelvic fracture, cardiac arrhythmia, cardiac embarrassment due to a haemothorax, and cardiovascular decompensation were seen. It was difficult to continue treatment during movement, especially maintaining an airway or providing adequate intermittent positive pressure ventilation. Seventy postoperative patients suffered few ill effects on being moved. Greater awareness of the dangers of moving critically ill patients within hospital is needed. Thorough preparation for the move and adequate maintenance of treatment during movement requires the skill of experienced medical staff.
在重症患者往返重症监护病房进行常规院内转运期间对其进行观察。每月有一名患者因转运直接发生严重心肺功能衰竭或死亡。观察到骨盆骨折再出血、心律失常、血胸导致的心脏窘迫以及心血管代偿失调。在转运过程中难以继续治疗,尤其是维持气道或提供充足的间歇正压通气。70例术后患者在转运时几乎未出现不良影响。需要提高对在医院内转运重症患者危险性的认识。转运前的充分准备以及转运过程中对治疗的充分维持需要经验丰富的医护人员的技能。