PICU intra hospital transport Patient Checklist

(see intra hospital transport guideline for more detailed information)

Action Completed
Aim
Safe transport with no intervention required during transport
Airway
ETT is well secured
Suction ETT within 30minutes prior to move
Place Emergency Transport box on bed-add ETT & suction catheter of
appropriate sizes
Breathing
Anaesthetic bag of appropriate size & manometer
Self inflating bag & face mask of appropriate size
Connect patient to transport ventilator at least 15 minutes prior to move
ETCo2 must remain monitored for move
Check ABG/CAB on transport ventilator
2 full oxygen cylinders for ventilated patient. 1 with twin o vac for suction.
Air cylinder if required
1 full oxygen cylinder for non-ventilated patient with twin o vac for suction
Circulation
All IVs are secured, patent and appropriately labelled
Volume is attached to patient and accessible
Enough fluid is left in all infusions to last length of transport plus one hour
Transducer secured to the patient or bed, cot or radiant warmer. Line
flushes removed from pump, turned off and tubing tidily assembled
Connect to transport monitor and set appropriate alarms
Chest Drains
Chest Drains anchored to bed, DO NOT CLAMP, carry clamps on bed for
emergency
Drugs
Draw up emergency drugs for unstable patients (adrenaline, saline flush,
aramine)
Disconnect all unused lines
Minimise infusions running to essentials only i.e. inotropes. Consider if
appropriate to take sedative infusions. Disconnect maintenance line
Environment
Remove all toys, excess linen and other clutter from patient bed/cot
Ensure all equipment is secured to the bed with clamps/lanyards
Bed/cot sides up
Cover patient with sheet/blanket for privacy during move
Plan to keep pt warm/cool as required (especially neonates)
Family
Ensure family are aware of transport and when child is expected back in
PICU
General
Ensure Patient History and all charts travel with the patient
Ensure patient is wearing 2 identification bands

Version 2 4/11/11
Version 2 4/11/11