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Proposal of a decision tree for the classification of road transport in biocontainment regimen using an isolator
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Proposal of a decision tree for the classification of road transport in biocontainment regimen using an isolator
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Journal Article
Proposal of a decision tree for the classification of road transport in biocontainment regimen using an isolator
2025
Overview
Introduction: ground biocontainment transport is essential for managing highly transmissible diseases, yet standardized decision- making tools for road-based transfers are lacking in civilian literature. This study aimed to develop an operational model to support clinical and logistical decisions during such transports. Materials and Methods: a decision tree was developed through retrospective analysis of 1.994 biocontainment transfers performed in Sicily between December 2020 and March 2022. Key variables included patient condition, use of life-support equipment, and transfer characteristics. The model was refined through structured post-mission briefings and categorized transfers into three complexity levels (C1-C3) based on clinical and logistical criteria. Results: patients were stratified by walking ability, need for monitoring or life support, and infectious risk. A total of 590 highcomplexity transfers used isolators, while 1.403 lower-complexity cases were managed with a biocontainment minibus. No critical equipment failures were recorded. The decision tree supported consistent planning and improved safety. Discussion: comparison with literature-based recommendations confirmed the model's validity and highlighted operational issues such as miscommunication and equipment integration. Integration with NEWS2 is proposed to enhance risk stratification. Conclusions: the proposed decision tree provides a reproducible framework for classifying biocontainment transport complexity. Prospective validation is needed to support its application in broader healthcare contexts.
Publisher
ANIARTI - Italian Critical Care Nurses Association
Subject
