A Systematic Review of the Prevalence and Types of Adverse Events in Interfacility Critical Care Transfers by Paramedics

OBJECTIVE: The aim of this study was to investigate if paramedics can safely transfer interfacility critically ill adult patients and to determine the prevalence and types of adverse events when paramedics lead interfacility critical care transfers.

METHODS: MEDLINE, Web of Science, Embase, and CINAHL databases were searched from 1990 up to February 2016. Eligibility criteria were adult patients (16 years and over), interfacility transfer (between two health care facilities), quantitative or qualitative description of adverse events, and a paramedic as the primary care provider or the sole health care provider.

RESULTS: Seven publications had paramedics as the sole health care provider conducting interfacility critical care transfers. All seven studies were observational studies published in the English language. The study duration ranged from 14 months to 10 years. The frequency of adverse events seen by paramedics in interfacility transfers ranges from 5.1% to 18%.

CONCLUSION: There is a gap in literature on the safety and adverse events in interfacility transfers by paramedics. The prevalence of in-transit adverse events is well established; however, because the published literature is lacking longitudinal monitoring of patients and only reporting in-transit events, we believe that further research in this area might provide the basis of paramedics safety in interfacility transfers.