PS52 2015: Transport of critically ill patients

 

·         This document applies to pre-hospital, inter-hospital and intra-hospital transport

·         This summary is for intra-hospital transport only

·         I have made some minor additions myself

 

List:

·         Liaison

·         Staffing

·         Preparation

·         Equipment

·         Monitoring

 

Principles:

·         Liaison

·         Staffing

·         Preparation

·         Equipment

·         Monitoring

·         Documentation (left this off the end)

 

Liaison:

·         Staff at origin: get handover

·         Staff at destination: give handover

·         Staff for transport

 

Staffing:

·         Doctor + nurse + orderly

·         Trained for transport

·         Able to use equipment

 

Preparation:

Optimise

·      ABC

·      Underlying condition

·      Consider sedation

·      Consider paralysis

Set up

·      Bed: sides up

·      Patient: positioning, pressure care

·      Attachments: secured

·      Monitoring: cables long and free

·      Infusions: lines long and free

Last minute checks

·      Bag-mask resuscitator with PEEP valve

·      Working ventilator

·      Oxygen cylinder full
(size C cylinder ~490L = 82 minutes at 6L/min)

·      Infusion bags full

·      Drainage bags empty

·      Lifesaving drugs to hand

·      Phone charged

 

Equipment:

Considerations

·      Size

·      Weight

·      Volume

·      Battery life

·      Durability

·      Ease of operation

Communication

·      Charged phone!

Supplies

·      Power

·      Oxygen cylinder for breathing

·      Oxygen cylinder for suction

Airway and breathing

·      Bag-mask resuscitator with PEEP valve

Circulation

·      Combined monitor/defibrillator/pacer

Drugs

·      Relevant

·      Labelled

 

Monitoring:

Airway and breathing

·      Pulse oximetry

·      Capnography if intubated

·      Monitors for ventilator disconnection and high pressure

Circulation

·      HR

·      Blood pressure: NIBP/ABP

·      Other pressures: CVP/ICP

·      ECG

Neuro

·      Conscious state

·      Pupils

Alarms

·      Visible

·      Audible

 

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