PS52 2015: Transport of critically ill patients

 

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

·        This summary is aimed at questions on intra-hospital transport only

·        I have made major modifications for the sake of simplicity and completeness

 

List:

·        Patient

·        Staff

·        Equipment

·        Monitoring

 

Patient:

Optimise

·      ABC

·      Underlying condition

·      Consider sedation

·      Consider paralysis

Set up

·      Patient: positioning, pressure care

·      Pumps: on single pole

·      Monitoring: in transport box

·      Lines: long, free, secured

 

Staff:

Transport team

·      Doctor

·      Nurse

·      Orderly

Liaison

·      Get hand-over

·      Give hand-over

 

Equipment:

Airway

·      Face mask

·      Guedel airway

·      ETT

·      Laryngoscope

Breathing

·      Bag-mask resuscitator with PEEP valve

·      Mechanical ventilator

Circulation

·      Monitor/defibrillator

·      IV access

·      Fluid giving set

Drugs

·      Hypnotic

·      Pressor

·      Relaxant

·      Emergency

Supplies

·      Power (phones, bed)

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

·      Infusions (i.e. bags full)

·      Drainage bags

Communication

·      DAT phone

·      Mobile phone

 

Monitoring:

Respiratory

·      Pulse oximetry

·      Capnography if intubated

·      Ventilator disconnection and high pressure alarms

Cardiovascular

·      HR

·      NIBP

·      ECG

·      Invasive pressure

Neurological

·      Conscious state

·      Pupils

 

Other:

·        Transport team must be appropriately trained

·        Alarms must be visible and audible

·        Considerations for equipment: size, weight, volume, battery life, durability, ease of operation

·        Drugs must be labelled

 

 

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