title: 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.
authors.affiliation: Lifeline Ground and Air Critical Care Transportation Services, The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA. KUE@bostonems.org
authors.forename: Ricky
authors.initials: R
authors.lastname: Kue
authors.forename: Paul
authors.initials: P
authors.lastname: Brown
authors.forename: Chyrl
authors.initials: C
authors.lastname: Ness
authors.forename: James
authors.initials: J
authors.lastname: Scheulen
mesh_terms: D000368:Aged; D015142:Baltimore; D003422:Critical Care / Q000592:standards*; D004496:Education, Continuing; D004632:Emergency Medical Services / Q000706:statistics & numerical data; D005260:Female; D006784:Hospitals, Teaching; D006801:Humans; D008297:Male; D008485:Medical Audit; D008875:Middle Aged; D017063:Outcome Assessment, Health Care / Q000379:methods; D010348:Patient Care Team; D010360:Patient Transfer / Q000592:standards*; D012189:Retrospective Studies; D013038:Specialization