ADVERSE EVENTS OCCURRING DURING INTERHOSPITAL TRANSFER OF THE CRITICALLY ILL

Objective - To determine what complications children have during inter hospital transfer for intensive care, and how often these complication s occur. Design - Observational study of all children transferred over a six month period, including interviews with patient escort, patient review, and severity of illness scoring. Main outcome measures - Timi ng and method of transport; complications occurring during transport; the equipment and experience of the escort; patient vital signs and pa ediatric risk of mortality score on admission; outcome and duration of intensive care. Results - Forty two (75%) of 56 children had adverse clinical events during transport. In 13 the event was life threatening . Inadequate circulatory and ventilatory support, inadequate monitorin g, equipment failures, and drug errors were common. Children who subse quently died were more likely to have had complicated transfers than t hose who survived. Conclusions - Most children had adverse clinical ev ents during transfer for intensive care. A number are transported by i nexperienced staff with inadequate or malfunctioning equipment. Standa rds for patient management and monitoring during transfer need to be e stablished. To reduce unsatisfactory care during transfer, it is neces sary to establish dedicated and specifically trained paediatric transp ort teams.