PubMed · 15459612
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Theodore R Delbridge, Donald M Yealy. 2004. Looking for a solution...to the solution?. https://doi.org/10.1016/j.annemergmed.2004.06.022
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BACKGROUND: Critical incidents are common during the inter-hospital transfer of sick patients, and infants are an especially vulnerable group. AIMS: To examine the effect of critical incident review on the number of adverse events during inter-hospital transfer of sick infants. METHODS: Critical incidents over an eight year period are reported from a single neonatal transfer service before and after major service changes were made. The changes were instigated as part of ongoing critical incident reviews. RESULTS: Changes made as a result of critical incident review significantly reduced the number of incidents contributed to by poor preparation, transport equipment or clinical problems, ambulance delays, and ambulance equipment failure. CONCLUSIONS: The continuous process of critical incident reporting and review can reduce the number of adverse events during the transfer of critically ill infants.
OBJECTIVE: Cardiopulmonary resuscitation (CPR) is frequently performed by allied health professionals, and, if undertaken in compromised positions, it may induce injury to the rescuer's spine. Back pain as an occupational symptom in manual workers has received considerable attention in the medical literature, but there is no report on the effect of CPR on back discomfort. This article reports a survey that explored the difficulties encountered by ambulance officers during the CPR procedure. METHODS: A questionnaire was sent to ambulance officers who had CPR experience through the Director and station officers-in-charge of the Fire Services Department in Hong Kong. RESULTS: Analysis of 318 completed questionnaires showed that the duration of the CPR procedure could last up to 32 min. Two hundred and ninety ambulance officers had experience in delivering CPR on a bed, and 60% of them often had to climb onto the bed with their legs overhanging to perform CPR. Eighty-nine percent were often required to turn their head or twist their back to look at the monitor during CPR. Almost 60% complained of always, and 36% sometimes, experiencing back discomfort during CPR. Only 4.5% had no experience of back discomfort during CPR. Seventy-six (24%) respondents suffered back injury, and as many as 62% of these 76 officers considered the cause of their back injury was related to CPR delivery. Nearly 50% of respondents reported that it was difficult to maintain balance and concurrently deliver CPR while travelling in the ambulance or when the patient was being transported from one location to another. CONCLUSIONS: Results of this survey suggest that there is a need to review the support given to ambulance officers to ensure safe administration of CPR, particularly during ambulance transport.
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