Carson K J, Drew B J
Cardiac Pathways Corporation, Sunnyvale, CA 94086.
Prog Cardiovasc Nurs. 1994 Fall;9(4):4-12.
Critically ill patients are frequently transported out of the intensive care unit (ICU) for diagnostic tests and procedures. Advanced diagnostic testing and increased patient acuity have influenced the level of nursing care required during intrahospital transport. Previous studies have documented deleterious patient outcomes during intrahospital transport, but none have evaluated twelve lead electrocardiograms (ECGs). Using a prospective design, this study sought to describe ECG changes during intrahospital transport. A secondary purpose was to describe the nursing implications of transporting the patients in this sample. A convenience sample of 29 critical care patients (14 cardiac, 8 neurological, 5 medical, 2 transplant) was selected from three ICUs at a university hospital. In addition to the standard, single bipolar lead monitor, patients were monitored with a portable, interpretative electrocardiograph with continuous 12 lead ST segment analysis. Results of this study indicate that cardiac events during intrahospital transport may go undetected because of current monitoring practices and the mechanics of transport.
重症患者经常被转运出重症监护病房(ICU)进行诊断检查和治疗程序。先进的诊断测试和患者病情的加重影响了院内转运期间所需的护理水平。先前的研究记录了院内转运期间对患者有害的结果,但没有一项研究评估过12导联心电图(ECG)。本研究采用前瞻性设计,旨在描述院内转运期间的心电图变化。第二个目的是描述在该样本中转运患者时的护理注意事项。从一所大学医院的三个ICU中选取了29例重症监护患者(14例心脏疾病患者、8例神经系统疾病患者、5例内科疾病患者、2例移植患者)作为便利样本。除了标准的单极导联监护仪外,还使用一台便携式、可解读的心电图仪对患者进行监测,并持续进行12导联ST段分析。本研究结果表明,由于目前的监测方法和转运机制,院内转运期间的心脏事件可能未被发现。