Critical care transfers of ventilator-dependent patients from operating theatres to Critical Care Units in a South African Metropole

Abstract

Background

Ventilated patients in the operating theatre who need transfer to other facilities, can contribute to delays and inefficencies in surgical and theatre resources. In 2018, an interhospital retrieval service was established to provide transfers between state hospitals in the Cape Town Metropole exclusively for intubated, post-operative patients. This study aims to describe the utilisation of the retrieval system and gain insights into retrieval patterns.

Methods

This retrospective observational study analysed all post-operative patients using the retrieval system between state hospitals in the Cape Town Metropole from July 2018 – December 2021, as recorded in an existing SPRINTT-OR registry.

Results

A total of 291 patients were included. Most patients retrieved were male (n = 186, 63.9 %), with a mean age of 34.95 (S ± 13.59). The median time interval from request to ambulance arrival was 61 min. Most patients (n = 184, 63.2 %) were transferred from a single Large Metro District Hospital (LMDH). Trauma surgery was the most common diagnostic category (n = 123, 42.3 %), followed by infective causes (n = 79, 27.1 %) and Obstetrics & Gynaecology (n = 52, 17.9 %).

Conclusion

This study provides insight into the retrieval needs of ventilated, post-operative patients across different healthcare facilities in an African metropolitan area who are transferred with a dedicated, specialised transfer service. It describes the system's use and provides insight into patient demographics, diagnoses, and transfer timing, as well as the role of Emergency Medical Services (EMS) in optimising the functioning of a healthcare system.