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TRANSPORT OF

CRITICALLY ILL PATIENTS


INTRODUCTION
Primary transport: from the incident site to a
medical facility.
Secondary transport (Inter-hospital): patient
moved between two hospitals, usually for an
increased level of medical care not available
locally.
Intrahospital transport: movement of patients
within the hospital or its campus for
investigations or treatment not available at
the ward or intensive care location. (eg CT
scan)
Before transport.

Full assessment of the patients condition


Assessment of the perceived advantage of the
transfer
Initiation of appropriate support including the
staff and resources, to achieve resuscitation and
stabilisation
Checking of transport equipment.
CONTRA -
INDICATION
INDICATION
DIAGNOS TIC PURPOSES POTENTIAL
e.g. CT SCAN , MRI. BENEFITS
THERAPEUTIC PURPOSE <POTENTIAL RISKS.
e.g.:- SURGERY, UNSTABLE (OR)
PACEMAKER POTENTIALLY
SPECIALIZED CARE UNSTABLE PATIENT .
e.g. :- EMERGENCY
DEPARTMENT TO ICU (or)
TERITIARY LEVEL
HOSPITAL.
ADVERSE EFFECTS OF
TRANSPORTATION
Hemodynamic instability
Hypertensive crisis
Systemic hypotension
Cardiac arrhythmias
Airway obstruction
Cardiac arrest
ESSENTIAL ELEMENTS

Communication.
Personnel.
Equipment.
Monitoring.
Handing over (Documents,
Information).
Medico legal and ethical aspects.
COMMUNICATION

PHYSICIAN TO NURSE TO

PHYSICIAN NURSE
INFORMATION

Reason for transport

The patient's condition

Equipment needed.

Just before leaving notify the receiving


department
ACCOMPANYING
PEROSONNEL
Two qualified personnel

Vehicle operator

Respiratory therapist
ACCOMPANYING EQUIPMENT

Airway management equipment

Medication

Electronic devices

Trolley

Oxygen cylinder
Ideal basic ambulance equipment requirements

Protective clothing and Splints


footwear Oxygen
Hard hats Suction unit
Robust gloves Secure stretcher
Safety glasses Extrication (spinal) board
Simple tools and cutting Neck collars
equipment Defibrillators
Communications Temperature control
Lighting and torches systems
Restraints for staff and Dressings
equipment Oxygen masks
AIRWAY MANAGEMENT
EQUIPMENT

Resuscitations Kit
Oxygen cylinder

Of ample volume to supply for projected needs plue30Mts reserve


Electronic Devices

Infusion pump
ECG Monitor

Pulse Oxymeter
STANDARD RESUSCITATION DRUGS
TROLLEY
PREPARING PATIENT FOR
TRANSPORT
Secure intra venous access
Airway stabilization
Trauma victims spinal mobilization
Naso gastnc tube
Foleys catheterization
Chest tube insertion
All drains
-under water seal
-urinary
-wound
Infusion pump & IV drips functioning properly
Soft wrist and leg restraints
Vital signs displayed on monitors
Patient is safely secured on a trolley
DOCUMENTATION

Indication for transport

Patient status during transport


vital signs
Level of consciousness
MONITORING

o Pulse

o Oxygen saturation

o BP,RR
ARRIVAL PROCEDURE

# Assessment

# Shifted

# Ventilators established

# Complete handover

# Documentation - patient status with time


CONCLUSION

Systematic approach

Careful planning

Proper use of personnel

Selection and availability of


appropriate equipment