A retrospective observational study of critically unwell patients retrieved from Thames Hospital between April 2018 and December 2020
Rory Miller 1 4 , Samuel Bell 2 , Lisa TenEyck 1 , Meg Topping 31 Thames Hospital, 601 Mackay Street, Thames, New Zealand.
2 Waitemata District Health Board, Auckland, New Zealand.
3 University of Otago Christchurch, Christchurch, New Zealand.
4 Corresponding author. Email: rory.miller@otago.ac.nz
Journal of Primary Health Care 13(3) 231-237 https://doi.org/10.1071/HC21058
Published: 25 August 2021
Journal Compilation © Royal New Zealand College of General Practitioners 2021 This is an open access article licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License
Abstract
INTRODUCTION: In New Zealand, critically ill patients who present to rural hospitals are typically treated, stabilised and transferred to facilities where more appropriate resources are available.
AIM: The aim of this study was to describe patients who presented critically unwell and required retrieval from Thames Hospital in the Waikato region.
METHODS: Notes were reviewed retrospectively for patients who were retrieved from Thames Hospital between 1 April 2018 and 31 December 2020. Patients were excluded if they were retrieved from the offsite birthing centre or their notes were not available to the authors.
RESULTS: During the study period, 56 patients were retrieved by intensive care teams based at Waikato, Starship or Auckland Hospitals. Patients had a median age of 57 years and most were female (60.7%). Māori patients were over-represented in the retrieval cohort compared with the population presenting to the emergency department (30.4% vs. 20.1%, P < 0.001). We found that 41% of patients presented after-hours when there was only one senior medical officer available on site and 70 procedures were performed, including rapid sequence induction, which was required by 19.6% of patients.
DISCUSSION: This study describes a population of critically unwell patients who were retrieved from a rural hospital. The key finding is that nearly half of these patients presented after-hours when there was only one senior medical officer available on site. This doctor also has sole responsibility for all other patients in the hospital. We recommend that referral centres streamline the retrieval processes for rural hospitals.
KEYwords: Rural hospitals; critical illness; hospital transfers.
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