Critical Procedure - Preparing a patient for transport

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For all procedures, ask yourself, 'does this need to be done 'now vs later'? And should this be done by 'me vs someone else?' Very often the answers will be 'now' and 'me' - so read on!

Preparing a patient for transport


Description

A checklist for preparing a patient for transport.

Procedure

Preparing a patient for transport.
  • communication
    • if possible, speak with the receiving centre and transport team before they arrive
    • re-discuss any issues just prior to departure
    • plan for communication en-route
      • cell phone, radio
      • to originating centre, to receiving centre, to transport medical director

  • appropriate transport device
    • vacuum mattress - often ideal but seldom available
    • clam shell
    • long board
    • directly on ambulance cot

  • transport position
    • supine
    • on side
    • sitting up

  • IV lines
    • secure
    • check are still working
    • consider second line

  • ET tubes
    • check position
    • secure well
    • recheck ventilation both sides just before leaving

  • chest tubes
    • if in doubt about the need for a chest tube it is usually best to discuss it with the receiving centre or transport team, or to insert it
    • tension pneumothorax is very difficult to diagnose in the in air and the ventilated patient with potential chest trauma should usually have chest tube/s inserted prior to transport

  • cuffs and balloons
    • may need slight deflation if flying at significant altitude, let the flight crew make the decisions

  • ventilation
    • may have to change over to the transport teams ventilator - check with them before they arrive
    • ensure functioning and that will have adequate power source en-route

  • elimination
    • consider urinary catheter
    • remove any faeces present

  • monitors
    • check connections
    • use monitor that can be used in the mode of transport
    • be prepared to swap over to the transport team's equipment

  • medications
    • consider anti-emetic
    • anaesthesia, analgesia, paralysis maintenance
    • seizure prophylaxis if indicated

  • prepare for interventions en-route
    • drugs pre-drawn up and labelled
    • head injured patient - mannitol, burr hole preparation
    • chest tube if not already inserted
    • RSI
    • defibrillation and pacing

  • documentation
    • send all charts and investigations
    • can be faxed during the transport if necessary

  • if escorting the patient, take a reliable means for charting on the move.
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Last modified: Thursday, 13 August 2020, 10:13 AM