Chapter 47. Safety During Transport of Critically Ill Patients

The care of acutely ill patients routinely includes transportation, both within a given hospital to undergo tests and procedures, and between hospitals, as patients may require transfer to other facilities for specialized services. Critically ill patients in particular commonly require such transfers and are at high risk for complications en route. Developing practices to reduce or minimize this necessary risk represents a potentially important area of patient safety research. This chapter focuses on transportation of critically ill patients by health professionals (paramedics, nurses, physicians and/or respiratory therapists) between hospitals (to receive higher levels of care) and within the hospital (for diagnostic or therapeutic procedures). Stabilization before transport, in the field or in the transferring hospital, and the mode of transferring patients from the field to specialized centers also present important research and policy questions. However, we regarded these issues as clinical research topics and quality improvement issues for the fields of pre-hospital and emergency medicine, rather than patient safety in general, and so do not review this literature here.