Emergency Department, Alice Ho Miu Ling Nethersole Hospital (Lee LLY, Lo WYL, Yeung KL, Chan JTS); Department of Emergency Medical Services, Kapiolani Community College, University of Hawaii, Honolulu Hawaii(Kalinowski E); Emergency Department, Pok Oi Hospital (Tang SYH).
World J Emerg Med. 2010;1(1):49-52.
The role of Inter-facility transport (IFT) of patients is an emerging specialty requiring service reorganization, diversion of major trauma to trauma center. This study aimed to determine the patients who are more prone to en route adverse event during the period of 22:00 to 07:00, based on critical in-patient needs provided by the Emergency Department (ED) nursing staff at Alice Ho Miu Ling Nethersole Hospital (AHNH).
This study included all 22:00 to 07:00 IFTs accompanied by ED nurses at AHNH for a period of 28 months from August 2006 until December 2008. The transports were reviewed for: (1) age, (2) gender, (3) transport configuration, (4) clinical category, and (5) physiological instability before transport.
A total of 79 patients were transported during the 22:00 to 07:00 timeframe within the study period. The types of patients were mainly neurosurgical emergencies (n=32; 40.5%), surgical emergencies (n=28; 35.4%), and upper gastrointestinal bleeding (UGIB) (n=11; 13.9%). En route adverse events were encountered by the accompanying nurses in 16 transports (20.3%) with a higher incidence of adverse events during transport of surgical emergencies, UGIB and patients who were physiological unstable before transport (P< 0.05).
A specialized transport team from the ED can assist other clinical departments by providing expert care during IFT. In spite of the high quality of care, adverse events do commonly occur.
患者的院内转运（IFT）是一个新兴的专业领域，需要进行服务重组，将重大创伤患者转至创伤中心。本研究旨在根据爱丽丝霍米林奈尔斯勒医院（AHNH）急诊部（ED）护理人员提供的重症住院病人需求，确定在 22:00 至 07:00 期间更易发生途中不良事件的患者。
本研究纳入了 2006 年 8 月至 2008 年 12 月期间，28 个月内所有由 ED 护士陪同的 22:00 至 07:00 IFT。对转运进行了回顾，包括：（1）年龄；（2）性别；（3）转运配置；（4）临床类别；（5）转运前生理不稳定。
在研究期间的 22:00 至 07:00 时间段内，共有 79 名患者进行了转运。患者类型主要为神经外科急症（n=32；40.5%）、外科急症（n=28；35.4%）和上消化道出血（UGIB）（n=11；13.9%）。在 16 次转运中，随行护士遇到了 16 次途中不良事件，外科急症、UGIB 和转运前生理不稳定的患者发生不良事件的发生率较高（P<0.05）。
ED 的专门转运团队可以通过在 IFT 期间提供专业护理来协助其他临床科室。尽管护理质量很高，但不良事件确实经常发生。
