Interhospital Transfer of Critically Ill Patients due to COVID-19 Related Respiratory Failure

Allen, Rebecca; Wanersdorfer, Karen; Zebley, James; Shapiro, Geoff; Coullahan, Tiffany; Sarani, Babak

INTRODUCTION: Interfacility transfer of patients with COVID-19 related acute respiratory failure is high risk due to the severity of respiratory failure and potential for crew exposure. This paper describes a hospital-based transport team's experience with interfacility transport of SARS-CoV-2 positive patients. METHODS: A retrospective study of transports for respiratory failure due to SARS-CoV-2 was performed. All transports were by a single critical care transport team. The team was already trained in advanced mechanical ventilation, blood gas interpretation, and management of shock. Guidance from the Centers of Disease Control was followed regarding use of personal protective equipment (PPE). RESULTS: Twenty patients were enrolled. Average patient age was 47 (standard deviation (SD) 12) years old. Average APACHE II and SOFA scores were 10 (SD 4) and 24 (SD 7), respectively. Average transport distance and time were 18 miles (SD 9) and 25 (SD 11) minutes, respectively. Nineteen patients were intubated, 9 of whom required advanced ventilation. Two patients were transported prone. One patient experienced unintentional extubation upon transfer from the stretcher to the destination facility bed. The patient was re-intubated without event. No crew members contracted SARS-CoV-2 infection. CONCLUSION: Interfacility transfer of severely ill SARS-CoV-2 positive patients is safe and feasible.