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TRANSPORT OF

CRITICALLY ILL
PATIENTS

Fachrul djamal Span Kic


Teuku Yasir, SpAn Kic

INTRODUCTION

CHALLENGE

BE AWARE OF RISKS

ROLE OF MEDICAL TEAM

TYPES OF TRANSFER

INTER HOSPITAL

INTRA - HOSPITAL

INDICATION

CONTRA
-INDICATION

DIAGNOS TIC
PURPOSES
e.g. CT
SCAN , MRI.

THERAPEUTIC
PURPOSE
e.g.:SURGERY, PACEMAKER

SPECIALIZED CARE
e.g. :- EMERGENCY
DEPARTMENT TO ICU
(or) TERITIARY LEVEL
HOSPITAL.

POTENTIAL
BENEFITS
<POTENTIAL RISKS.
UNSTABLE (OR)
POTENTIALLY
UNSTABLE PATIENT
.

ADVERSE EFFECTS OF
TRANSPORTATION
Hemodynamic

instability
Hypertensive crisis
Systemic hypotension
Cardiac arrhythmias
Airway obstruction
Cardiac arrest

POTENTIAL MISHAPS
Accidental extubation.
Ventilator disconnects.
ECG disconnects.
Monitor power failure.
Vaso active drug interruption.
Intravenous infiltration or
disconnection.

ESSENTIAL
ELEMENTS

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

COMMUNICATION
PHYSICIAN

TO

PHYSICIAN

NURSE

TO

NURSE

INFORMATION

Reason for transport

The patient's condition

Equipment needed.

Just before leaving notify the


receiving department

COMMUNICATION
INTRA

INTER

Transport service .

Emergency dept to ICU


Cath lab

ICU to emergency dept

ICU to

Copy of medical record.

Complete hand over

Radiology
dept
Theatre

ACCOMPANYING
PEROSONNEL

Two qualified personnel

Vehicle operator

Respiratory therapist

ACCOMPANYING
EQUIPMENT

Airway management equipment

Medication

Electronic devices

Trolley

Oxygen cylinder

AIRWAY MANAGEMENT
EQUIPMENT

Resuscitations Kit

AIRWAY MANAGEMENT
EQUIPMENT
RESUSCITATION
KIT
ORAL AIRWAYS

STILLET

OXYGEN
TUBING/
BAINSCIRCUITS

AMBU BAG
WITH& MASK

LARYNGOSCOPE &
BLADE OF DIFERENT
SIZES

ET TUBE SECURING SUCTION


CATHETER
TAPES
ET TUBE OF
DIFFERENT
SIZES
ADEHSIVE TAPE
SUCTION
APPARATUS

WATER SOLUBLE
LUBRICANT

NEBULISER

Oxygen cylinder

Of ample volume to supply for projected needs


plue30Mts reserve

Electronic Devices

ECG Monitor

Pulse Oxymeter

Infusion pump

STANDARD
RESUSCITATION DRUGS

TROLLEY

Pre - departure
Equipment must be
checked for

Monitors
Oxygen cylinders are full
Manual Resuscitation bag
Airway & intubations equipment
Emergency drugs & muscle
relaxant
Chest tube clamp
Patient notes, imaging films lab

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

Oxygen saturation

BP,RR

IN-TRANSIT PROCEDURE

A best route

Lift should be reserved before hand

Status of patient checked at


intervals

Continuous monitoring

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