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Patient Transfer (patient + transfer)

Distribution by Scientific Domains

Medical Sciences	100%

Selected Abstracts

Prediction of respiratory insufficiency in Guillain-Barré syndrome

ANNALS OF NEUROLOGY, Issue 6 2010
Christa Walgaard MD
Objective Respiratory insufficiency is a frequent and serious complication of the Guillain-Barré syndrome (GBS). We aimed to develop a simple but accurate model to predict the chance of respiratory insufficiency in the acute stage of the disease based on clinical characteristics available at hospital admission. Methods Mechanical ventilation (MV) in the first week of admission was used as an indicator of acute stage respiratory insufficiency. Prospectively collected data from a derivation cohort of 397 GBS patients were used to identify predictors of MV. A multivariate logistic regression model was validated in a separate cohort of 191 GBS patients. Model performance criteria comprised discrimination (area under receiver operating curve [AUC]) and calibration (graphically). A scoring system for clinical practice was constructed from the regression coefficients of the model in the combined cohorts. Results In the derivation cohort, 22% needed MV in the first week of admission. Days between onset of weakness and admission, Medical Research Council sum score, and presence of facial and/or bulbar weakness were the main predictors of MV. The prognostic model had a good discriminative ability (AUC, 0.84). In the validation cohort, 14% needed MV in the first week of admission, and both calibration and discriminative ability of the model were good (AUC, 0.82). The scoring system ranged from 0 to 7, with corresponding chances of respiratory insufficiency from 1 to 91%. Interpretation This model accurately predicts development of respiratory insufficiency within 1 week in patients with GBS, using clinical characteristics available at admission. After further validation, the model may assist in clinical decision making, for example, on patient transfer to an intensive care unit. ANN NEUROL 2010;67:781,787 [source]

TRANSFER OF FACIALLY INJURED ROAD TRAUMA VICTIMS AND ITS IMPACT ON TREATMENT

ANZ JOURNAL OF SURGERY, Issue 6 2005
Martin Batstone
Background: Road trauma is a common cause of severe facial injuries. The aim of the present study is to define patients involved, and determine the effect of their geographical origin on treatment and follow up. Methods: All patients over 14 years of age suffering facial injuries caused by road trauma presenting to the two study hospitals from 1994 to 1999 were identified and details were collected on demographic details and treatment. Results: Four hundred and nine patients met the inclusion criteria. The majority required hospital transfer. Young men were the most frequently injured group of patients. Patients from peripheral regions had significant delays in transfer and treatment. They were made fewer outpatient appointments but attended at the same frequency as patients from the immediate region of the study hospitals. Conclusions: To minimize delays the process of patient transfer needs to be streamlined and education of staff in peripheral hospitals undertaken regarding facial injuries. [source]

Clonal dissemination of epidemic methicillin-resistant Staphylococcus aureus in Belgium and neighboring countries

CLINICAL MICROBIOLOGY AND INFECTION, Issue 5 2000
A. Deplano
Objectives To determine the diversity of pulsed-field gel electrophoresis (PFGE) types among epidemic strains of methicillin-resistant Staphylococcus aureus (MRSA) recovered in Belgium, France, Germany and The Netherlands over the period 1981,94. Methods MRSA strains collected in a multicenter survey in Belgium (n = 171) and from reference laboratories in neighboring countries (n = 102) were characterized by PFGE analysis using the SmaI enzyme. Results In total, 32 PFGE types were found. Epidemic PFGE type 1, first recognized in 1984, accounted for 82% of Belgian strains (87% of hospitals) and 51% of European MRSA strains. Four other internationally epidemic PFGE types (types 8, 10, 11 and 12) were less widely disseminated and more recently detected (1991,94), each recovered from two or three countries. International spread of two PFGE types was linked to transfer of colonized patients to Dutch hospitals from another country where this type was frequently recovered. Conclusions Genotypic analysis indicated widespread distribution of several outbreak-associated MRSA strains over large European regions, which was in some instances related to interhospital patient transfer. These findings underscore the need for standardized international surveillance and control of MRSA transmission between healthcare institutions across Europe. [source]

REDUCING TIME TO URGENT SURGERY BY TRANSPORTING RESOURCES TO THE TRAUMA PATIENT

ANZ JOURNAL OF SURGERY, Issue 4 2007
Morgan P. McMonagle
Background: Time to definitive trauma care directly influences patient survival. Patient transport (retrieval) services are essential for the transportation of remotely located trauma patients to a major trauma centre. Trauma surgical expertise can potentially be combined with the usual retrieval response (surgically supported response) and delivered to the patient before patient transportation. We identified the frequency and circumstances of such surgically supported retrievals. Methods: Retrospective review of trauma patients transported by the NRMA CareFlight, New South Wales Medical Retrieval Service, Australia, from 1999 to 2003, identifying patients who had a surgically supported retrieval response and an urgent surgical procedure carried out before patient transportation to an major trauma centre. Results: Seven hundred and forty-nine trauma interhospital patient transfers were identified of which 511 (68%) were categorized as urgent and 64% of which were rural based. Three (0.4%) patients had a surgically supported retrieval response and had an urgent surgical procedure carried out before patient transportation. All patients benefited from that early surgical intervention. Conclusion: A surgically supported retrieval response allows for the more timely delivery of urgent surgical care. Patients can potentially benefit from such a response. There are, however, important operational considerations in providing a surgically supported retrieval response. [source]