Adverse clinical events during intrahospital transport by a specialized team: a preliminary report

Abstract

Background: Caring for patients during intrahospital transport is a high-risk activity. Few data exist on the use of specialized transport teams similar to the teams used for out-of-hospital transport.

Objective: To describe the experience with a dedicated, intra-hospital transport program, to report the rate of clinically significant adverse events, and to examine types of adverse events, interventions provided, and outcomes.

Methods: Patient transports within an academic quaternary-care hospital from November 2007 through April 2008 were retrospectively reviewed. Adverse events were defined as extubation, code team activation, death, sustained arrhythmia, hypoxia exceeding 5 minutes, hypotension exceeding 20% of baseline systolic or diastolic blood pressure and requiring intervention, use of physical restraints, or acute change in mental status.

Results: A total of 3383 charts were reviewed (91.8% of all completed transports).The overall rate of adverse events was 1.7% (59 events). Most events were related to hypoxia (25/59) and blood pressure changes (25/59). One extubation and one code team activation occurred. Most interventions involved adjustments to oxygen therapy (22/59) and vasopressor management (18/59). Only 12 (20.3%) of the transports with adverse events were aborted, more often during magnetic resonance imaging (χ(2) = 6.86, df = 1, P = .01) and in older patients (mean [SD], 70.8 [14.2] vs 58.7 [14.9] years; P = .02).

Conclusions: The rate of clinically significant adverse events during patient transport by a specialized team is relatively low. Further studies are needed to compare effectiveness and mortality benefits between intrahospital transport teams and traditional transport teams.