Why MICAS?

Abstract

IntroductionThe Mobile Intensive Care Ambulance Service (MICAS) was initiated in 1996 to assess, stabilise and transfer critically ill patients from a referring hospital to a receiving hospital to meet their clinical needs. Critically ill patients are transferred throughout Ireland to an increased level of care, repatriation for continuity of care following specialist treatment, specialist critical care services or in some instances, are considered too unstable to be transported by local staff.  In 2015, it was estimated that approximately 1000 ICU patients are transported per annum (Murphy, Dwyer). These numbers are likely to increase as a result of the reorganisation of health services, the development of hospital groups, the establishment of the hub and spoke critical care services and introduction of trauma centres. This increases the requirement of inter hospital transfers throughout the country.AimsThe aim of this audit was to establish the rationale for a critical care retrieval service and to evaluate the adverse events for inter hospital transport of critically ill patients in Ireland over a 3 year periodMethodsA retrospective chart review of all patients transported by MICAS between January 2015 and December 2017 was undertaken. Clinical records were reviewed for acuity and for adverse events.  Results339 patients were transported in this timeframe with 7% experiencing an adverse event overall.ConclusionThe MICAS data shows an increasing number of critically ill patients transferred by MICAS within the timeframe. The rationale for MICAS includes the provision by a specialist team with transport specific equipment with reduced adverse events.