INTRAHOSPITAL TRANSPORT OF CRITICALLY ILL PEDIATRIC-PATIENTS
INTRAHOSPITAL TRANSPORT OF CRITICALLY ILL PEDIATRIC-PATIENTS
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DOI：
10.1097/00003246-199509000-00020
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发表时间：
1995-09-01
影响因子：
8.8
通讯作者：
ORR, RA
中科院分区：
文献类型：
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作者：
WALLEN, E;VENKATARAMAN, ST;ORR, RA
目的：确定医院内转运过程中不良事件的发生频率；确定转运过程中治疗干预的需求；检验医院内转运过程中发生的不良事件与转运过程本身有关的假设；确定预测转运过程中不良事件发生和需要主要治疗干预措施的因素。设计：前瞻性收集数据的两阶段研究。在第一阶段，我们检查了不良事件的发生率，治疗干预的要求，以及预测不良事件的因素和治疗干预的要求。在第二阶段，我们验证了运输过程中的不良事件是由运输过程本身引起的假设。背景：一所拥有250张床位的大学儿童医院和50张床位的重症监护病房。患者：研究的第一阶段包括139名患者的180次院内运输。这些运送的病人包括：a)从手术室、急诊室或普通病房转到ICU；b)从ICU转到手术室；c)从ICU进行诊断或治疗。研究的第二阶段包括85例患者的输液。干预：无。测量和主要结果：在输液前和过程中测量生命体征和血氧饱和度。在第一阶段，23.9%的输液没有不良事件发生。在71.7%的运输工具中，至少有一个生理变量发生了显著变化，在10%的运输工具中，至少有一个与设备相关的事故。在13.9%的运输工具中，至少有一次主要干预是为了应对生理恶化或与设备相关的事故。没有人在运输过程中被捕或死亡。机械通气患者对大手术的需求率为34.4%，非机械通气患者为9.5%。Logistic回归分析显示，运输前治疗干预评分系统和运输时间都与重大干预需求和生理恶化显著相关，而只有运输时间与装备相关事件相关。患者的年龄和陪同运输的护送人数并不影响不良事件的发生频率。在II期研究患者转运之前，没有患者变得体温过低，生理变量的变化总是
Objectives: To determine the frequency of adverse events during intrahospital transport; to determine the requirement of therapeutic interventions during transport; to test the hypothesis that adverse events that occur during intrahospital transport are due to the transport process itself; and to determine the factors that predict the occurence of adverse events and the requirement of major therapeutic interventions during transport.Design: A two-phase study in which data were prospectively collected. In phase I, we examined the occurrence rate of adverse events, the requirement for therapeutic interventions, and the factors that predicted adverse events and the requirement of therapeutic interventions. In phase II, we tested the hypothesis that adverse events during transport were due to the transport process itself.Setting: A 250-bed university children's hospital with a 50-bed intensive care unit (ICU).Patients: Phase I of the study consisted of one hundred and eighty intrahospital transports in 139 patients. These transports included patients who were transferred: a) to the ICU from the operating room, emergency department, or the general ward; b) from the ICU to the operating room; and c) from the ICU for diagnostic or therapeutic procedures. Phase II of the study consisted of 89 transports in 85 patients.Interventions: None.Measurements and Main Results: Vital signs and oxygen saturation were measured before and during transport.In phase I, there were no adverse events in 23.9% of transports. There was a significant change in at least one physiologic variable in 71.7% of transports, and at least one equipment-related mishap in 10% of transports. At least one major intervention was performed in 13.9% of transports in response to physiologic deterioration or an equipment-related mishap. There were no arrests or deaths during transport. The requirement for a major procedure was 34.4% in mechanically ventilated patients vs. 9.5% in nonventilated patients. Logistic regression analysis showed that both pretransport Therapeutic Intervention Scoring System and the duration of transport were significantly associated with the requirement of a major intervention and physiologic deterioration, while only the duration of transport was associated with an equipment-related event. The age of the patient and the number of escorts accompanying the transport did not affect the frequency of adverse events. Before transport in phase II study patients, no patient became hypothermic, the changes in physiologic variables were always