Adverse events during interfacility transfers by ground advanced life support services

Area of Science:

• Emergency Medicine
• Critical Care Transport
• Patient Safety

Background:

• Interfacility transfers are common in emergency medical services (EMS).
• Identifying risk factors for adverse events during these transfers is crucial for improving patient outcomes.
• Advanced life support (ALS) interventions during transport may indicate patient instability.

Purpose of the Study:

• To identify risk factors associated with adverse events during interfacility transfers by ALS.
• To analyze the frequency of ALS interventions and patient deterioration during transport.
• To inform the development of safer ALS transfer protocols.

Main Methods:

• Retrospective case series over four years.
• Analysis of 351 transports conducted by three rural/suburban ALS EMS units.
• Classification of patients by illness/injury, transporting staff, and ongoing therapy to correlate with ALS intervention and deterioration.

Main Results:

• The rate of interfacility transfers increased consistently during the study period.
• Cardiac conditions were the most frequent reason for transfer (44%).
• Patient deterioration and need for ALS intervention were linked to medication infusions (p < .05) but not to the presence of hospital staff (p > .40).

Conclusions:

• Interfacility transfers by ALS involve a low risk of cardiac arrest.
• Patients with medication infusions are at increased risk of deterioration and require more ALS interventions during transport.
• The presence of hospital staff did not significantly impact patient outcomes or the need for ALS interventions.