Analysis of Adverse Events during Intrahospital Transportation of Critically Ill Patients
Table 1
Frequency of adverse events observed during intrahospital transport of critically ill patients.
Adverse events
Physiological alterations
38
Variation in HR ≥ 20 BPM
13
Hypertension
8
Hypotension
5
Variation in RR ≥ 10 RPM
4
Agitation
4
Saturation drop < 90%
1
Hypoglycemia
1
Bleeding
1
Vomiting
1
Equipment failures
20
End of O2 cylinder
15
End of the CIP battery
5
Team failures
17
Interrupted ventilation for 1 minute
3
Medication CIP interrupted
3
Loss of venous access
2
Returned from SC without medication forwarded
2
O2 tank accidentally closed
1
Patient without nasal catheter
1
Moved to the wrong location
1
Lack of communication between shifts
1
Medication error (wrong patient)
1
Secretion in the orotracheal tube
1
Taking medication for transportation without need
1
Delays
11
Delayed attendance
3
Obstacle on the transport path
3
Lift delay
2
Transported in bed not compatible with the lift
1
Team disagreement about medication
1
Door of the exam room locked
1
CIP: continuous infusion pump, SC: surgical center, O2: oxygen, HR: heart rate, BPM: beats per minute, RR: respiratory rate, RPM: breaths per minute, and ICU: Intensive Care Unit.