Interfacility Transport of Critically Ill Patients

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.