Interhospitala transporter av intensivvårdskrävande patienter - Förekomsten av fysiologiska förändringar

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Sammanfattning: Background: In the year of 2018, there is a shortage of intensive care facilities. Therefore, more and more patients in need of intensive care are being transported between hospitals. These transportations, also known as interhospital transports, require more from the anesthetic nurse to insure that the care provided is given out in a safe and patient-friendly way.Aim: The purpose of this study is to describe the presence of the hemodynamic and respiratory changes with the intensive care patient within the context of the interhospital transports.Methods: A quantitative retrospective observational study was done through examining journals. All interhospital transportation of patients in need of intensive care and respiratory nursed patients that were carried out from a hospital in the west of Sweden, during the time period of January 1st, 2015 to March 31st, 2018, were collected. Based on these, intensive care unit - and the intensive care ambulance records were examined using a drafted review template.Results: The analysis showed that the largest physiological change seemed to occur within hemodynamics, mainly on systolic blood pressure. Based on an average, values of the blood pressure between the intensive care department and the interhospital transport were compared. The finding shows that 57% (=8) of patients had a decreasing blood pressure, while 36% (n=5) had an increasing blood pressure. Furthermore, an improvement in the saturation was seen during transportation in all cases except one, where the saturation was at the same level in the intensive care unit as during transportation. More than half of the patients were treated with vasoactive drugs. Documentation of vital parameters were missing in most journals at the beginning of each transport.The loss was of varying times, the maximum being 65 minutes.Conclusion: During the interhospital transports, both hemodynamic and respiratory changes occur to varying degrees. In-depth knowledge and awareness around these changes can give the anesthetist nurse the opportunity to improve patient safety during the transports. What these changes mean to the individual Intensive care patient in an extension is something that needs further exploration in the future.Keywords: Interhospital transports, nurse anesthetists, patients in need of intensive care, critically ill, intensive care, patient safety, physiological changes

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