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The Development and Evaluation of a Paramedic-Staffed Mobile Intensive Care Unit for Interfacility Patient Transport

Published online by Cambridge University Press:  28 June 2012

Robert M. Domeier ,
James D. Hill  and
Roger D. Simpson
Robert M. Domeier*
Affiliation:
Clinical Instructor, University of Michigan/St. Joseph Mercy Hospital Combined Emergency Medicine Residency Program, Ann Arbor, Michigan
James D. Hill
Affiliation:
Quality Assurance Coordinator, Huron Valley Ambulance, Ann Arbor, Michigan
Roger D. Simpson
Affiliation:
Operations Manager, Huron Valley Ambulance, Ann Arbor, Michigan
*
Department of Emergency Medicine, St. Joseph Mercy Hospital, 5301 E. Huron River Drive, P.O. Box 995, Ann Arbor, MI 48106USA
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Abstract

Objective:

As the role of paramedics evolves, evaluation of their ability to accomplish an expanded scope of practice is necessary. The objective of this study was to determine whether specially trained paramedics can monitor and treat patients appropriately during interfacility transports that traditionally have required the use of supplemental, hospital-based personnel.

Methods:

A paramedic-staffed mobile intensive care unit was developed as a cooperative program between Huron Valley Ambulance and the Washtenaw/Livingston County Medical Control Authority. This prospective observational study involved 111 patients requiring interfacility transport, conveyed by a paramedic-staffed mobile intensive care unit. A change in the Acute Physiologic and Chronic Health Evaluation (APACHE II) score components of mean arterial pressure, heart rate, and respiratory rate at the beginning and end of the transport was used to evaluate the ability of the paramedics to accomplish the transfer appropriately.

Results:

APACHE II scares increased in 20 patients, decreased in 16, and were unchanged in 75. The mean value for the change in APACHE score was 0.11 (95% confidence interval: −0.11−0.33).

Conclusion:

Specially trained paramedics can monitor and treat patients appropriately during interfacility transfers that traditionally would have required supplementation with additional hospital staff.

Keywords

APACHE IIemergency medical servicesinterfacility transfermedical controlmobile intensive care unitparamedicpatient transfer
Type
Original Research
Information
Prehospital and Disaster Medicine , Volume 11 , Issue 1 , March 1996 , pp. 37 - 43
Copyright
Copyright © World Association for Disaster and Emergency Medicine 1996

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References

1. Dunn, JD: Patient transfers. In: Henry, GL (ed): Emergency Medicine Risk Management. Dallas: American College of Emergency Physicians, 1991, pp 321–329.Google Scholar
2. Rubenstein, DG, Treister, NW, Kapoor, AS, et al. : Transfer of acutely ill cardiac patients for definitive care, demonstrated safety in 755 cases. JAMA 1988;259:1695–1698.Google Scholar
3. Schneider, C, Gomez, M, Lee, R: Evaluation of ground ambulance, rotor-wing, and fixed-wing aircraft services. Crit Care Clin 1992;8:533–564.CrossRefGoogle ScholarPubMed
4. American College of Emergency Physicians: Appropriate interhospital patient transfer. Ann Emerg Med 1993;22:766–767.CrossRefGoogle Scholar
5. Gore, JM, Corrao, JM, Goldberg, RJ, et al. : Feasibility and safety of emergency interhospital transport of patients during early hours of acute myocardial infarction. Arch Intern Med 1989;149:353–355.CrossRefGoogle ScholarPubMed
6. Wright, IH, McDonald, JC, Rogers, PN, et al. : Provision of facilities for secondary transport of seriously ill patients in the United Kingdom. BJM 1988;296:543–545.CrossRefGoogle ScholarPubMed
7. Macnab, AJ: Optimal escort for interhospital transport of pediatric emergencies. J Trauma 1991;31:205–209.CrossRefGoogle ScholarPubMed
8. Ranter, RK, Tompkins, JM: Adverse events during interhospital transport: Physiologic deterioration associated with pretransport severity of illness. Pediatrics 1989;84:43–48.Google Scholar
9. Gore, JM, Haffajee, CI, Goldberg, RJ, et al. : Evaluation of an emergency cardiac transport system. Ann Emerg Med 1983;12:675–678.CrossRefGoogle ScholarPubMed
10. Connolly, HV, Fetcho, S, Hageman, JR: Education of personnel involved in the transport program. Crit Care Clin 1992;8:481–490.CrossRefGoogle ScholarPubMed
11. Washtenaw/Livingston County Medical Control Authority: Interhospital patient transfers (W/L Co MCA EMS Treatment protocols), 1992.Google Scholar
12. Knaus, WA, Draper, EA, Wagner, DP, Zimmerman, JE: APACHE II: A severity of disease classification system. Crit Care Med 1985;13:818–829.CrossRefGoogle ScholarPubMed
13. Burney, RE, Passini, L, Hubert, D, et al. : Comparison of aeromedical crew performance by patient severity and outcome. Ann Emerg Med 1992;21:375–378.Google Scholar
14. Indiana developing first statewide paramedic physician-extender program. EMS Insider 1993;20:1–3.Google Scholar
15. Bion, JF, Wilson, IH, Taylor, PA: Transporting critically ill patients by ambulance: audit by sickness scoring. BJM 1988;296:170.Google Scholar
16. Bion, JF, Edlin, SA, Ramsay, G, et al. : Validation of a prognostic score in critically ill patients undergoing transport. BJM 1985;291:432–434.CrossRefGoogle ScholarPubMed