Evidence map›Paper›PMID 34172228›Full record

Observational studyAir medical journal

Decision Making and Interventions During Interfacility Transport of High-Acuity Patients With Severe Acute Respiratory Syndrome Coronavirus 2 Infection.

Ruben D Troncoso, Eric M Garfinkel, David Leon, Sandra M Lopez, Andrew Lin, Dennis Jones, Shawn Trautman, Matthew J Levy, Asa M Margolis

Abstract readObservational Study
PubMed Full text at PMC Publisher
In one paragraph

Observational study in Air medical journal. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed.

  1. Trial
  2. Article
  3. Review
  4. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Ruben D TroncosoDepartment of Emergency Medicine, Johns Hopkins University School of Medicine, Baltimore, MD; Johns Hopkins Lifeline Critical Care Transportation Program, Johns Hopkins University School of Medicine, Baltimore, MD. Electronic address: rtronco1@jhmi.edu.
Eric M GarfinkelDepartment of Emergency Medicine, Johns Hopkins University School of Medicine, Baltimore, MD.
David LeonDepartment of Emergency Medicine, Johns Hopkins University School of Medicine, Baltimore, MD.
Sandra M LopezDepartment of Emergency Medicine, Johns Hopkins University School of Medicine, Baltimore, MD.
Andrew LinDepartment of Emergency Medicine, Johns Hopkins University School of Medicine, Baltimore, MD.
Dennis JonesJohns Hopkins Lifeline Critical Care Transportation Program, Johns Hopkins University School of Medicine, Baltimore, MD.
Shawn TrautmanJohns Hopkins Lifeline Critical Care Transportation Program, Johns Hopkins University School of Medicine, Baltimore, MD.
Matthew J LevyDepartment of Emergency Medicine, Johns Hopkins University School of Medicine, Baltimore, MD; Johns Hopkins Lifeline Critical Care Transportation Program, Johns Hopkins University School of Medicine, Baltimore, MD.
Asa M MargolisDepartment of Emergency Medicine, Johns Hopkins University School of Medicine, Baltimore, MD; Johns Hopkins Lifeline Critical Care Transportation Program, Johns Hopkins University School of Medicine, Baltimore, MD.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveThere are limited data regarding the typical characteristics of coronavirus disease 2019 (COVID-19) patients requiring interfacility transport or the clinical capabilities of the out-of-hospital transport clinicians required to provide safe transport. The objective of this study is to provide epidemiologic data and highlight the clinical skill set and decision making needed to transport critically ill COVID-19 patients.

methodsA retrospective chart review of persons under investigation for COVID-19 transported during the first 6 months of the pandemic by Johns Hopkins Lifeline was performed. Patients who required interfacility transport and tested positive for severe acute respiratory syndrome coronavirus 2 by polymerase chain reaction assay were included in the analysis.

resultsSixty-eight patients (25.4%) required vasopressor support, 35 patients (13.1%) were pharmacologically paralyzed, 15 (5.60%) were prone, and 1 (0.75%) received an inhaled pulmonary vasodilator. At least 1 ventilator setting change occurred for 59 patients (22.0%), and ventilation mode was changed for 11 patients (4.10%) during transport.

conclusionThe safe transport of critically ill patients with COVID-19 requires experience with vasopressors, paralytic medications, inhaled vasodilators, prone positioning, and ventilator management. The frequency of initiated critical interventions and ventilator adjustments underscores the tenuous nature of these patients and highlights the importance of transport clinician reassessment, critical thinking, and decision making.

Indexed as

Clinical CompetenceAdultAgedAged, 80 and overClinical Decision-MakingCombined Modality TherapyCOVID-19Critical CareCritical IllnessFemaleHumansMaleMarylandMiddle AgedPatient AcuityPatient Transfer

Identifiers

PMID34172228
PMCPMC8020076

What OpenQuestion holds

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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.