• Shao-Peng Huang, Yu-Yuan Lin, Yuh-Shin Kuo, Yu-Fen Huang, Shu-Chun Wu, Kuo-Tien Huang, Chien-Hsin Lu, Po-Wei Chiu, I-Chen Lin, Ying-Hsin Chang, Chao-Wei Chin, Hung-Chieh Chang, and Chih-Hao Lin.
• Department of Emergency Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, 70403 Tainan, Taiwan.
• J Formos Med Assoc. 2022 Sep 1; 121 (9): 1864-1871.

Background/PurposeInterfacility transfer (IFT) in Asian communities is seldom discussed. We aimed to describe the characteristics of IFT in Taiwan and to explore the adequacy of care during transfer.MethodsA retrospective, cross-sectional, descriptive study was conducted using standardized, paper-based interfacility ambulance transfer records between 1 January 2018 and 31 January 2018 from Tainan City, Taiwan. The mode of patient care needed was classified as advanced life support (ALS) or basic life support (BLS) cares based on clinical conditions. ALS providers were defined as physicians and EMT-Paramedics, while BLS providers were defined as nurse practitioners, nurses, EMT-1s and EMT-2s.ResultsOf the 377 (227 [60.2%] were >65 years old; 219 [58.1%] were male) IFTs enrolled in the final analysis, 210 (55.7%) patients met the ALS transfer criteria, with poor consciousness (n = 158), tachypnea (n = 17), tachycardia (n = 5), bradycardia (n = 7), hypertension (n = 12), hypotension (n = 13), hypoxia (n = 4), endotracheal intubation (n = 18), a tracheostomy (n = 25), a precipitous labor (n = 1), and after resuscitation for out-of-hospital cardiac arrest (n = 10) or in-hospital cardiac arrest (n = 3). None of the patients who required ALS care had adequate ambulance staffing. Of the 167 BLS IFTs, 9 (5.4%) patients deteriorated and required ALS care during transportation, which included worsened consciousness (n = 2), tachycardia (n = 1), hypertension (n = 2), hypotension (n = 1), and hypoxia (n = 3). The rates of deterioration during BLS-transferals from the emergency departments, general wards, nursing facilities, and unknown areas were 4.8%, 4.7%, 7.7%, and 7.1%, respectively (p = 0.93).ConclusionThe patient care during IFT in Taiwan is inadequate currently and should warrant attention.Copyright © 2022 Formosan Medical Association. Published by Elsevier B.V. All rights reserved.

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