Lifeline Ground and Air Critical Care Transportation Services, The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
Am J Crit Care. 2011 Mar;20(2):153-61; quiz 162. doi: 10.4037/ajcc2011478.
Caring for patients during intrahospital transport is a high-risk activity. Few data exist on the use of specialized transport teams similar to the teams used for out-of-hospital transport.
To describe the experience with a dedicated, intra-hospital transport program, to report the rate of clinically significant adverse events, and to examine types of adverse events, interventions provided, and outcomes.
Patient transports within an academic quaternary-care hospital from November 2007 through April 2008 were retrospectively reviewed. Adverse events were defined as extubation, code team activation, death, sustained arrhythmia, hypoxia exceeding 5 minutes, hypotension exceeding 20% of baseline systolic or diastolic blood pressure and requiring intervention, use of physical restraints, or acute change in mental status.
A total of 3383 charts were reviewed (91.8% of all completed transports).The overall rate of adverse events was 1.7% (59 events). Most events were related to hypoxia (25/59) and blood pressure changes (25/59). One extubation and one code team activation occurred. Most interventions involved adjustments to oxygen therapy (22/59) and vasopressor management (18/59). Only 12 (20.3%) of the transports with adverse events were aborted, more often during magnetic resonance imaging (χ(2) = 6.86, df = 1, P = .01) and in older patients (mean [SD], 70.8 [14.2] vs 58.7 [14.9] years; P = .02).
The rate of clinically significant adverse events during patient transport by a specialized team is relatively low. Further studies are needed to compare effectiveness and mortality benefits between intrahospital transport teams and traditional transport teams.
在院内转运过程中照顾患者是一项高风险的活动。目前几乎没有关于使用类似于院外转运团队的专业转运团队的数据。
描述一个专门的院内转运项目的经验，报告有临床意义的不良事件发生率，并检查不良事件类型、提供的干预措施和结果。
回顾 2007 年 11 月至 2008 年 4 月在一所学术四级保健医院内进行的患者转运。将不良事件定义为拔管、急救小组激活、死亡、持续心律失常、缺氧超过 5 分钟、低血压超过基础收缩压或舒张压的 20%并需要干预、使用身体约束或精神状态急性改变。
共回顾了 3383 份病历（所有完成转运的病历的 91.8%）。不良事件的总发生率为 1.7%（59 例）。大多数事件与缺氧（25/59）和血压变化（25/59）有关。发生了一次拔管和一次急救小组激活。大多数干预措施涉及调整氧疗（22/59）和血管加压药管理（18/59）。只有 12 例（20.3%）有不良事件的转运被中止，在磁共振成像（χ(2) = 6.86，df = 1，P =.01）和老年患者（平均[标准差]，70.8[14.2] vs 58.7[14.9]岁；P =.02）中更常见。
由专业团队进行的患者转运过程中出现有临床意义的不良事件的发生率相对较低。需要进一步的研究来比较院内转运团队和传统转运团队之间的效果和死亡率优势。
