Electrocardiographic changes in critically ill adults during intrahospital transport

Critically ill patients are frequently transported out of the intensive care unit (ICU) for diagnostic tests and procedures. Advanced diagnostic testing and increased patient acuity have influenced the level of nursing care required during intrahospital transport. Previous studies have documented deleterious patient outcomes during intrahospital transport, but none have evaluated twelve lead electrocardiograms (ECGs). Using a prospective design, this study sought to describe ECG changes during intrahospital transport. A secondary purpose was to describe the nursing implications of transporting the patients in this sample. A convenience sample of 29 critical care patients (14 cardiac, 8 neurological, 5 medical, 2 transplant) was selected from three ICUs at a university hospital. In addition to the standard, single bipolar lead monitor, patients were monitored with a portable, interpretative electrocardiograph with continuous 12 lead ST segment analysis. Results of this study indicate that cardiac events during intrahospital transport may go undetected because of current monitoring practices and the mechanics of transport.