Quality Review of Prone Patient Transport Protocol

This is a retrospective quality review of LifeFlight Nova Scotia's prone patient transport protocol.

Electronic patient care records were queried for acute respiratory distress syndrome, prone position, proning, supine to prone, and prone to prone between February 2017 and June 2022. Eligible electronic patient care records were reviewed for demographics (sex, age, and weight); method of transports (ambulance, rotor wing, or fixed wing); duration of transports; mechanical ventilation parameters; medication infusions; arterial blood gases; occurrences of mild hypoxemia (any oxygen saturation [SpO₂] < 88% or decrease in SpO₂ > 5%); hypotension (any episode of MAP < 65 mm Hg); severe hypoxemia (any SpO₂ < 80% or decrease in SpO₂ > 10%); refractory hypotension (mean arterial pressure < 65 mm Hg not responsive to vasopressor/inotropes); cardiac arrests; and displacement of central lines, arterial lines, and endotracheal tubes.

Seventeen prone patients were transported by ambulance, rotor wing, and fixed wing with 4 occurrences of mild hypotension, 4 occurrences of mild hypoxemia, and 1 occurrence of refractory hypotension.

Interfacility transfer of prone patients by a dedicated critical care team is feasible with minimal adverse occurrences while ensuring patients have access to the specialized lifesaving care they require.