Transport of critically ill adults

Area of Science:

• Emergency Medicine
• Critical Care Medicine
• Transport Medicine

Background:

• Interhospital transport of critically ill patients presents significant risks due to physiological instability and complex monitoring requirements.
• Effective management strategies are crucial to mitigate transport-related hazards.

Purpose of the Study:

• To evaluate the safety and outcomes of interhospital transport for critically ill adult patients.
• To develop and validate a risk-scoring system correlating transport risk with illness severity.

Main Methods:

• Retrospective study of 204 critically ill adult patients transferred to a tertiary medical center.
• Development of a risk-scoring system based on patient condition and severity of illness.
• Analysis of transport modes (air vs. surface ambulance), distances, durations, and patient outcomes.

Main Results:

• 61% of patients were classified as high-risk for transport.
• All patients survived the transport phase.
• 71.6% of patients were eventually discharged from the hospital.
• Hospital mortality showed a significant correlation with the risk-scoring system (p < .01) and increased five-fold with higher illness severity.

Conclusions:

• Interhospital transport of severely ill patients is safe when accompanied by appropriate hemodynamic stabilization and continuous monitoring.
• The developed risk-scoring system effectively predicts transport risk and correlates with hospital mortality.
• Specialized transport teams can successfully manage critically ill patients during interhospital transfers.