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.