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Medication Administration in Critical Care Transport of Adult Patients with Hypoxemic Respiratory Failure

Published online by Cambridge University Press:  16 July 2015

Susan R. Wilcox ,
Mark S. Saia ,
Heather Waden ,
Susan J. McGahn ,
Michael Frakes ,
Suzanne K. Wedel  and
Jeremy B. Richards
Susan R. Wilcox*
Affiliation:
Department of Emergency Medicine, Massachusetts General Hospital, Boston, Massachusetts USA Boston MedFlight, Bedford, Massachusetts USA
Mark S. Saia
Affiliation:
Boston MedFlight, Bedford, Massachusetts USA
Heather Waden
Affiliation:
Boston MedFlight, Bedford, Massachusetts USA
Susan J. McGahn
Affiliation:
Boston MedFlight, Bedford, Massachusetts USA
Michael Frakes
Affiliation:
Boston MedFlight, Bedford, Massachusetts USA
Suzanne K. Wedel
Affiliation:
Boston MedFlight, Bedford, Massachusetts USA
Jeremy B. Richards
Affiliation:
Division of Pulmonary, Critical Care and Sleep Medicine, Department of Internal Medicine, Beth Israel Deaconess Medical Center, Boston, Massachusetts USA
*
Correspondence: Susan R. Wilcox, MD 55 Fruit Street Boston, Massachusetts 02114 USA E-mail: [email protected]
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Abstract

Introduction

Critical care transport (CCT) teams must manage a wide array of medications before and during transport. Appreciating the medications required for transport impacts formulary development as well as staff education and training.

Problem

As there are few data describing the patterns of medication administration, this study quantifies medication administrations and patterns in a series of adult CCTs.

Methods

This was a retrospective review of medication administration during CCTs of patients with severe hypoxemic respiratory failure from October 2009 through December 2012 from referring hospitals to three tertiary care hospitals.

Results

Two hundred thirty-nine charts were identified for review. Medications were administered by the CCT team to 98.7% of these patients, with only three patients not receiving any medications from the team. Fifty-nine medications were administered in total with 996 instances of administration. Fifteen drugs were each administered to only one patient. The mean number of medications per patient was 4.2 (SD=1.8) with a mean of 1.9 (SD=1.1) drug infusions per patient.

Conclusions

These results demonstrate that, even within a relatively homogeneous population of patients transferred with hypoxemic respiratory failure, a wide range of medications were administered. The CCT teams frequently initiated, titrated, and discontinued continuous infusions, in addition to providing numerous doses of bolused medications.

WilcoxSR , SaiaMS , WadenH , McGahnSJ , FrakesM , WedelSK , RichardsJB . Medication Administration in Critical Care Transport of Adult Patients with Hypoxemic Respiratory Failure. Prehosp Disaster Med. 2015;30(4):1-5.

Keywords

intravenous infusionsmedication systemspumps, infusiontransportation of patients
Type
Brief Report
Information
Prehospital and Disaster Medicine , Volume 30 , Issue 4 , August 2015 , pp. 431 - 435
Copyright
© World Association for Disaster and Emergency Medicine 2015 

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References

1. Roeder, JR. Flight team configuration of an air medical serivce. Top Emerg Med. 1994;16(4):66-72.Google Scholar
2. Gebremichael, M, Borg, U, Habashi, NM, et al. Interhospital transport of the extremely ill patient: the mobile intensive care unit. Crit Care Med. 2000;28(1):79-85.Google Scholar
3. Saha, AS, Langridge, P, Playfor, SD. The pattern of intravenous drug administration during the transfer of critically ill children by a specialist transport team. Paediatr Anaesth. 2006;16(10):1063-1067.Google Scholar
4. Singh, JM, MacDonald, RD, Bronskill, SE, Schull, MJ. Incidence and predictors of critical events during urgent air-medical transport. CMAJ. 2009;181(9):579-584.Google Scholar
5. Singh, JM, Ferguson, ND, MacDonald, RD, et al. Ventilation practices and critical events during transport of ventilated patients outside of hospital: a retrospective cohort study. Prehosp Emerg Care. 2009;13(3):316-323.Google Scholar
6. Singh, JM, Macdonald, RD, Ahghari, M. Critical events during land-based interfacility transport. Ann Emerg Med. 2014;64(1):9-15.Google Scholar
7. Taxis, K, Barber, N. Ethnographic study of incidence and severity of intravenous drug errors. BMJ. 2003;326(7391):684.Google Scholar
8. Keers, RN, Williams, SD, Cooke, J, Ashcroft, DM. Causes of medication administration errors in hospitals: a systematic review of quantitative and qualitative evidence. Drug Saf. 2013;36(11):1045-1067.Google Scholar
9. Warren, J, Fromm, RE Jr, Orr, RA, et al. American College of Critical Care Medicine. Guidelines for the inter- and intrahospital transport of critically ill patients. Crit Care Med. 2004;32(1):256-262.Google Scholar
10. Beninati, W, Meyer, MT, Carter, TE. The critical care air transport program. Crit Care Med. 2008;36(7 Suppl):S370-S376.Google Scholar
11. Institute for Safe Medication Practices (ISMP). ISMP list of high-alert medications in acute care settings. ISMP Web site. http://www.ismp.org/tools/highalertmedications.pdf. Published 2014. Updated 2014. Accessed March 12, 2015.Google Scholar