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Published on: January 17, 2011
Benefits of and Untoward Events during Intrahospital Transport of Pediatric Intensive Care Unit Patients
M M Harish1, Suhail Sarwar Siddiqui1, Natesh R Prabu1
1Department of Anaesthesia Critical Care and Pain, Division of Critical Care Medicine, Tata Memorial Hospital, Mumbai, Maharashtra, India.
Insights
Intrahospital transport of critically ill pediatric patients can be safe with proper preparation. This study audited transport events and benefits, finding that careful planning minimizes risks and can lead to improved patient therapy.
Area of Science:
- Pediatric Critical Care Medicine
- Patient Safety
- Healthcare Logistics
Background:
- Intrahospital transport of critically ill children poses risks.
- Limited literature exists on untoward events (UEs) and benefits during pediatric intrahospital transport.
- Auditing UEs and benefits is crucial for optimizing transport protocols.
Purpose of the Study:
- To audit untoward events (UEs) during intrahospital transport of critically ill pediatric patients.
- To evaluate the benefits of intrahospital transport for pediatric patients.
- To inform best practices for safe and effective patient movement within the hospital.
Main Methods:
- Retrospective audit of 80 critically ill pediatric patients (<18 years) transported from the Intensive Care Unit (ICU).
- Data collected included transport destination, accompanying medical personnel, UEs, and therapeutic benefits.
- Analysis focused on adverse events and positive outcomes of intrahospital transport.
Main Results:
- Several adverse events occurred, including intubation (5%), intercostal drain placement (3.75%), cardiopulmonary resuscitation (7.5%), catheter removal (3.75%), drain dislodgement (5%), and accidental extubation (3.75%).
- Transport indirectly led to antibiotic therapy changes in 30% of patients.
- Direct therapeutic benefits included interventions in 25% of patients.
Conclusions:
- Critically ill children can be transported safely with adequate pretransport preparations.
- Effective preparation helps avoid major untoward events (UEs).
- Transport can benefit patients through timely changes in therapy.
Background And Aims:
The transport of critically ill patients for procedures or imaging outside the Intensive Care Unit (ICU) is potentially hazardous; hence, the transport process must be organized and efficient. The literature about benefits of and untoward events (UEs) during intrahospital transport of pediatric critically ill patient is scarce. We, therefore, audited the UEs during and benefits of intrahospital transport of critically ill pediatric patients in our ICU.
Subjects And Methods:
Eighty critically ill pediatric (<18 years) cancer patients, transported from the ICU for either diagnostic or therapeutic procedure over a period of 6 months, were included in the study. The data collected included the destination (computed tomography scan, intervention radiology, magnetic resonance imaging scan, and operation theater), accompanying medical personnel, UEs, and benefits obtained during transport.
Results:
Among eighty pediatric patients, the median age was 8 years (range 2-17 years). During the transport, four (5%) patients required endotracheal intubation, three (3.75%) patients required intercostal drain placement, and six (7.5%) patients required cardiopulmonary resuscitation. Accidental removal of central venous catheter was reported in three (3.75%) patients, drain came out in four (5%) patients, and three (3.75%) patients had accidental extubation. Transport indirectly led to a change in antibiotic therapy in 24 (30%) patients and directly helped in change of therapy in the form of interventions in 20 (25%) patients.
Conclusion:
Critically ill children can be transported safely with adequate pretransport preparations, which may help in avoiding major UEs and benefit the patient by change in the therapy.
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