Related Experiment Videos
Adverse events occurring during interhospital transfer of the critically ill
Insights
Most pediatric intensive care transfers involve adverse clinical events, with many due to inexperienced staff and faulty equipment. Improving pediatric transport requires dedicated, trained teams and established care standards.
Area of Science:
- Pediatric critical care medicine
- Transport medicine
Background:
- Interhospital transfer of critically ill children is common.
- Complications during transfer can negatively impact patient outcomes.
Purpose of the Study:
- To identify the types and frequency of complications in children during interhospital transfer for intensive care.
- To assess factors contributing to these complications.
Main Methods:
- Observational study of 56 children over six months.
- Data collected via escort interviews, patient record review, and illness severity scoring.
- Key outcomes included transport complications, escort experience, and patient vital signs.
Main Results:
- 75% of children (42/56) experienced adverse clinical events during transport.
- 13 events were life-threatening.
- Common issues included inadequate support, monitoring, equipment failure, and medication errors.
Conclusions:
- The majority of pediatric intensive care transfers involve adverse events.
- Inadequate staffing and equipment are significant contributing factors.
- Establishing standards and dedicated, trained pediatric transport teams is crucial to improve care quality.
Objective:
To determine what complications children have during interhospital transfer for intensive care, and how often these complications occur.
Design:
Observational study of all children transferred over a six month period, including interviews with patient escort, patient review, and severity of illness scoring.
Main Outcome Measures:
Timing and method of transport; complications occurring during transport; the equipment and experience of the escort; patient vital signs and paediatric risk of mortality score on admission; outcome and duration of intensive care.
Results:
Forty two (75%) of 56 children had adverse clinical events during transport. In 13 the event was life threatening. Inadequate circulatory and ventilatory support, inadequate monitoring, equipment failures, and drug errors were common. Children who subsequently died were more likely to have had complicated transfers than those who survived.
Conclusions:
Most children had adverse clinical events during transfer for intensive care. A number are transported by inexperienced staff with inadequate or malfunctioning equipment. Standards for patient management and monitoring during transfer need to be established. To reduce unsatisfactory care during transfer, it is necessary to establish dedicated and specifically trained paediatric transport teams.