Articoli originali
V. 42 N. 3 (2025)
https://doi.org/10.4081/scenario.2025.612

Proposal of a decision tree for the classification of road transport in biocontainment regimen using an isolator

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##plugins.generic.dates.accepted##: 28 giugno 2025
Pubblicato: 24 luglio 2025
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Biocontenimento, controllo delle infezioni, bioisolatore, evacuazione medica, schema decisionale

Autori

Ulrico Angeloni
Ufficio 11 - Ministero della Salute - Direzione Generale della Prevenzione Sanitaria, Roma, Italia.
Federico D'Urso
federico.durso@gmail.com
https://orcid.org/0009-0009-8667-0729
Croce Rossa Italiana, Dipartimento di Sanità Pubblica, Sezione Siciliana, Palermo, Italia.
Edoardo Falcone
https://orcid.org/0009-0005-3433-0328
Croce Rossa Italiana, Dipartimento di Sanità Pubblica, Sezione Siciliana, Palermo, Italia.
Mara Gracy Basile
https://orcid.org/0009-0007-2543-7881
Croce Rossa Italiana, Dipartimento di Sanità Pubblica, Sezione Siciliana, Palermo, Italia.
Virgilio Costanzo
Croce Rossa Italiana, Dipartimento di Sanità Pubblica, Sezione Siciliana, Palermo, Italia.
Sabrina Menghini
IN. MM. S.r.l - In Manibus Meis, Ferrara, Italia.

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 high-complexity 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.

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Proposal of a decision tree for the classification of road transport in biocontainment regimen using an isolator. (2025). Scenario® - Il Nursing Nella Sopravvivenza, 42(3). https://doi.org/10.4081/scenario.2025.612
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