Common Emergency Procedures

Common Emergency Procedures

Transfers and retrievals

Types of transfer/retrieval

  • Intrahospital transfer (e.g. to ICU or to CT scan).

  • Interhospital transfer (e.g. because the patient requires a specialist investigation or intervention; there is a lack of critical care beds in the referring hospital; to repatriate the patient).

  • retrieval (e.g. from the roadside).1

  • retrieval (an interhospital transfer using a specialist team from another healthcare facility to retrieve the patient).

Decision to transfer

  • Is the transfer necessary?

  • Is further stabilization required; will further stabilization delay urgent treatment (e.g. surgical decompression of intracranial haematomas)?1

  • Is everything that might be needed to treat any reasonably predictable complication available to accompany the patient?

  • Are the correct staff, equipment, and transfer apparatus available?

Pitfalls/difficult situations

  • Most problems during transfer result from inadequate stabilization prior to departure, or failure to continue optimal treatment and monitoring during transfer.

1With the exception of retrievals, and transfers for urgently required treatments, there will be sufficient time to fully stabilize the patient. A ‘scoop and run’ policy should only be adopted where there are insufficient resources available to resuscitate A, B, and C.

Further reading

Ahmed I, et al. Risk management during inter-hospital transfer of critically ill patients: making the journey safe. Emerg Med J 2008; 25: 502-5.

Association of Anaesthetists of Great Britain and Ireland. Interhospital transfer, AAGBI safety guideline. London: AAGBI, 2009.

Intensive Care Society. Guidelines for the transport of the critically ill adult. London: Intensive Care Society, 2011.

Macartney I, et al. Transfer of the critically ill adult patient. Br J Anaesth CEPD Rev 2001; 1(1): 12-15.

Rapid sequence intubation

Anatomical landmarks

  • The cricoid cartilage may be identified immediately inferior to the thyroid cartilage; it feels like a wedding ring below the skin (Fig. 17.1).

Fig. 17.1 Anatomy of the cricoid cartilage.

Jun 13, 2016 | Posted by in CRITICAL CARE | Comments Off on Common Emergency Procedures

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