transport of critically ill
Post on 30-Nov-2014
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TRANSPORT OF CRITICALLY ILL
PATIENTDr vipul thakkar
Consultant – critical care
Cims hospital , ahmedabad
TRANSPORT OF MECHANICALLY VENTILAATED PT Transport monitor, Airway- expert, transport ventilator Check ET Position, FIX, suction, confirm
receiveing facility
Special need- PEEP, MODE of ventilation
ASK YOURSELF- IS PT. IS SHIFTABLE ? High vasopressors – refractory shock ?
High FiO2, High oxygen requirement..
? Benefits of transfer vs. risk during ……?
TRANSFER – SHOULD “ mobile but seamless continuation of ICU environment”
IN HOSPITAL TRANSFER Checklist for MAN, MACHINE, drugs
Prior communication with team members and destination team
Assess route-time of transfer
Document the process , events.
WHO should accompany pt.? What equipment, monitors needed ? Adequacy of equipment - Amount, size,
functional status
PERSONNEL Doctor, nurse, assistant Clear chain of responsibility Proper hand over referring transfer
receiving doctor
EQUIPMENTS, DRUGS Familiar Adequate battery back up for monitor, Check, o2 cylender- suction , defib.
Empty drainage bags
TRANSPORT PLAN AND CONDUCT Pt. special need
Staff- adequacy, awareness of responsibility
Receiving facility- informed, prepared
specific transport condition….road, distance, weather, vehicle, lighting
Check the route Proper take over by receiving team
DOCUMENTATION Clinical status before, during , after
transfer
Pt. condition- trend
Medicolegal implications
In end, evaluate process of transfer- for quality improvement
NO TRANSFER without fixing ABC…
Secure Airway when doubt, borderline indication- INTUBATION
Adequate i. v. access-
Unco-operative pt. without secured airway- very dangerous –
Put URINARY CATH, RT, CVC in indicated pt.
before transfer.not
Do not remove support , monitoring before TRANSPORT
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