Risk of mishaps during intrahospital transport of critically ill patients.

BACKGROUND: Mishaps are common during transport and may have major impacts on patients.

AIMS: The main objectives of our study are: first to determine the incidence of complications during intra hospital transports (IHT) of critically ill patients, and second, to determine their risk factors.

METHODS: All intra hospital transports for diagnostic and therapeutic purposes of patients consecutively admitted in an 18-bed medical surgical intensive care unit in an university hospital, have been studied prospectively during a period of six months (September 1st 2012 to February 28th 2013).

RESULTS: Of 184 transports observed (164 patients), 85 (46.2%) were associated with mishaps. Eighty two mishaps were patient-related (44.5%).Oxygen desaturation (30 cases), agitation (24 cases) and hemodynamic instability (15 cases) were predominantly. One case of cardiac arrest and 3 cases of accidental extubation were occurred during IHT. Seventy three systems-based mishaps were noted (39.6%). Emergency transports, mechanical ventilation and positive end-expiratory pressure (PEEP) ≥ 6 cmH2O were independent risk factors for a higher rate of mishaps. In our study, complications did not statistically increase ventilator-associated pneumonia.

CONCLUSION: This study confirms that IHT of critically-ill patients still involves considerable risks and mishaps incidence remains high.