Critical Care Transport




Critical Care Transport



Listen




Introduction



Intensive care unit (ICU) patients are at their most vulnerable during the period of transport to and from the ICU.




Definitions and Terms




  • ▪  Transport: Includes travel to the unit from the floor, emergency room, or operating room and from the unit to the floor, operating room, and off-site test and procedure locations.




Techniques




  • ▪  Prior to transport, the transferring personnel should ensure that the receiving personnel has received report on the patient’s status, if applicable.
  • ▪  If the patient is going off-site for a test or procedure, the stability of the patient should be evaluated immediately prior to transport to ensure that the requirement for the test outweighs the risk inherent in the transport.
  • ▪  Prior to transport, all relevant data should be reviewed to ensure that the performance of a planned procedure will not put the patient at additional risk (ie, does the patient have an intravenous [IV] contrast allergy).
  • ▪  Where applicable, lower risk alternatives that can be performed in the ICU should be considered (ie, portable anterior-posterior chest x-ray in ICU vs. formal posterior-anterior and lateral in radiology department).
  • ▪  Are adequate numbers of skilled personnel available to make the trip safely and is adequate coverage available in the ICU?
  • ▪  Appropriate medications and an administration route (ie, patent IV line) should be identified prior to transport.

    • —Make sure resuscitation medications are available where appropriate (ie, atropine).
    • —Make sure all infusion medications are sufficiently full to last through planned transport or that replacement supplies are available.

  • ▪  Additional equipment needed for safe transport should be available (ie, portable suction for chest tubes).
  • ▪  Nursing interventions should be performed prior to transport to diminish the risk of nosocomial infections.

    • —Keep head of bed elevated during transport where possible to diminish the risk of regurgitation and aspiration.
    • —Empty urinary drainage bag to prevent reflux of urine into the bladder.

  • ▪  Evaluate ventilatory status prior to transport to ensure that ICU ventilatory and oxygen support can be reproduced both during transport and at receiving site.
  • ▪  Are adequate oxygen supplies available during transport (check cylinder supply)?
  • ▪  Is a portable ventilator necessary to reproduce positive end-expiratory pressure (PEEP) or ventilator mode during transport?
  • ▪  Is there a ventilator at destination?
  • ▪  Is there a face mask with a self-reinflating resuscitation bag immediately available?

Only gold members can continue reading. Log In or Register to continue

Jan 10, 2019 | Posted by in CRITICAL CARE | Comments Off on Critical Care Transport
Premium Wordpress Themes by UFO Themes