Table 5

Examples of recorded adverse events

Transfer characteristics

Adverse event

Severity (grade 1–3)^a

Pulmonary embolus

PaO₂ on departure 4.2 kPa; not intubated; PaO₂ on arrival 4.7 kPa

3

Oesophageal bleeding

Only one peripheral intravenous line; no accompanying physician; active bleeding; PaO₂ on arrival 6.7 kPa

3

Sepsis, rhabdomyolysis

RI; shock on arrival

2

Imminent RI; Wegener's granulomatosis

No blood pressure measured on the road (160 km); PaO₂ on arrival 6.7 kPa, SaO₂ 86%

1

Pulmonary embolus

No accompanying physician; RI on arrival

2

ARDS, MOF

SaO₂ 93% at departure, 69% on arrival

3

Streptococcal pneumonia/sepsis; imminent RI

Not intubated (despite advice); norepinephrine via peripheral intravenous line

3

Sleep apnoea syndrome; RI

PaO₂ on departure 6.9 kPa; during transport SaO₂↓ 74% and cardiac ischaemia; no physician

3

Haemorragic shock; mechanical ventilation

No accompanying physician; active bleeding (3 units packed cells on the road); oxygenation problems

3

Infectious endocarditis; mechanical ventilation

No physician; haemodynamically unstable on the road

1

Septic shock; imminent RI

Not intubated (despite advice); RI on arrival

3

Septic shock; MOF

Norepinephrine via peripheral intravenous line

2

Suicide attempt (benzodiazepine)

Deep coma; not intubated; apnoea en route; cyanotic on arrival

3

Postsurgical; mechanical ventilation

Oxygen supply breakdown before arrival

3

COPD, pneumonia

Shortage of oxygen before arrival

3

Haemodyalisis postsurgical

No blood pressure measured on the road

1

Active bleeding digestive tract

Only one peripheral intravenous line

1

ARDS; mechanical ventilation

Ambulance breakdown; 40 min delay

1

^aGrades of severity: grade 1 = deviation from guidelines/protocol; grade 2 = of vital importance – immediate action needed on arrival; and grade 3 = of vital importance – immediate action needed on arrival – event probably avoidable. ARDS, acute respiratory distress syndrome; MOF, multiple organ failure; PaO₂, arterial oxygen tension; RI, respiratory insufficiency (imminent need for mechanical ventilation); SaO₂, arterial oxygen saturation.

Ligtenberg et al. Critical Care 2005 9:R446   doi:10.1186/cc3749