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Interfacility Transport of Critically Ill Patients.

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Recent advances in interfacility critical care transport have improved patient outcomes through better selection, optimization, and well-equipped teams. However, more high-quality studies are needed to standardize transport quality and regulations.

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Area of Science:

  • Critical care medicine
  • Emergency medical services
  • Transport medicine

Background:

  • Interfacility critical care transport is essential for transferring critically ill patients to specialized care centers.
  • Advances in medical technology and protocols have aimed to improve the safety and efficacy of these transports.
  • Standardization and quality assessment remain challenges in the field.

Purpose of the Study:

  • To review and synthesize recent advancements in interfacility critical care transport.
  • To identify key areas of progress and persistent challenges in the field.
  • To provide a foundation for future research and practice improvements.

Main Methods:

  • An integrative review of scientific literature, including peer-reviewed publications, book chapters, and professional organization guidelines.
  • Qualitative analysis of selected manuscripts focusing on transport definitions, team composition, and specific considerations.
  • Screening of 496 manuscripts, with 21 ultimately included in the qualitative synthesis.

Main Results:

  • Significant progress has been made since 2004 in critical care transport, including enhanced monitoring and en route management.
  • Appropriate patient selection, pretransport optimization, and well-resourced transport teams are crucial for mitigating clinical deterioration.
  • Notable advances in transport modalities (air vs. ground), team composition, and training have been observed.

Conclusions:

  • While advances in critical care transport are evident, a lack of high-quality controlled studies hinders further progress.
  • Professional organization guidelines are not consistently linked to enforceable regulations, impacting standardization and quality verification.
  • Future research should focus on addressing the identified gaps to improve the standardization and quality of interfacility critical care transport.