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TRANSPORT OF CRITICALLY ILL PATIENTS

TRANSPORT OF CRITICALLY ILL PATIENTS. Mrs. Prabha P (Ag. WARD SISTR,MICU) CHRISTIAN MEDICAL COLLEGE VELLORE. INTRODUCTION. CHALLENGE BE AWARE OF RISKS ROLE OF MEDICAL TEAM. TYPES OF TRANSFER. INTRA - HOSPITAL. INTER HOSPITAL. CONTRA -INDICATION. INDICATION.

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TRANSPORT OF CRITICALLY ILL PATIENTS

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  1. TRANSPORT OF CRITICALLY ILL PATIENTS Mrs. Prabha P (Ag. WARD SISTR,MICU) CHRISTIAN MEDICAL COLLEGE VELLORE

  2. INTRODUCTION • CHALLENGE • BE AWARE OF RISKS • ROLE OF MEDICAL TEAM

  3. TYPES OF TRANSFER INTRA - HOSPITAL INTER HOSPITAL

  4. CONTRA -INDICATION INDICATION • POTENTIAL BENEFITS <POTENTIAL RISKS. • UNSTABLE (OR) POTENTIALLY UNSTABLE PATIENT . • DIAGNOS TIC PURPOSES e.g. CT SCAN , MRI. • THERAPEUTIC PURPOSE e.g.:- SURGERY, PACEMAKER • SPECIALIZED CARE e.g. :- EMERGENCY DEPARTMENT TO ICU (or) TERITIARY LEVEL HOSPITAL.

  5. ADVERSE EFFECTS OF TRANSPORTATION • Hemodynamic instability • Hypertensive crisis • Systemic hypotension • Cardiac arrhythmias • Airway obstruction • Cardiac arrest

  6. POTENTIAL MISHAPS • Accidental extubation. • Ventilator disconnects. • ECG disconnects. • Monitor power failure. • Vaso – active drug interruption. • Intravenous infiltration or disconnection.

  7. ESSENTIAL ELEMENTS • Communication. • Personnel. • Equipment. • Monitoring. • Handing over (Documents, Information). • Medico legal and ethical aspects.

  8. COMMUNICATION • PHYSICIAN TO PHYSICIAN • NURSE TO NURSE

  9. INFORMATION • Reason for transport • The patient's condition • Equipment needed. • Just before leaving notify the receiving department

  10. COMMUNICATION INTRA INTER • Emergency dept to ICU • ICU to • Complete hand over • Transport service . • ICU to emergency dept • Copy of medical record. Cath lab Radiology dept Theatre

  11. ACCOMPANYING PEROSONNEL • Two qualified personnel • Vehicle operator • Respiratory therapist

  12. ACCOMPANYING EQUIPMENT • Airway management equipment • Medication • Electronic devices • Trolley • Oxygen cylinder

  13. AIRWAY MANAGEMENT EQUIPMENT Resuscitations Kit

  14. AIRWAY MANAGEMENT EQUIPMENT • LARYNGOSCOPE & BLADE OF DIFERENT SIZES • RESUSCITATION KIT • AMBU BAG WITH& MASK • ORAL AIRWAYS • ET TUBE SECURING • TAPES • SUCTION CATHETER • ET TUBE OF DIFFERENT SIZES • STILLET • WATER SOLUBLE LUBRICANT • OXYGEN TUBING/ BAINSCIRCUITS • ADEHSIVE TAPE • NEBULISER • SUCTION APPARATUS

  15. Oxygen cylinder Of ample volume to supply for projected needs plue30Mts reserve

  16. Electronic Devices Infusion pump ECG Monitor Pulse Oxymeter

  17. STANDARD RESUSCITATION DRUGS

  18. TROLLEY

  19. Pre - departure Equipment must be checked for • Monitors • Oxygen cylinders are full • Manual Resuscitation bag • Airway & intubations equipment • Emergency drugs & muscle relaxant • Chest tube clamp • Patient notes, imaging films lab and radiographic studies

  20. PREPARING PATIENT FOR TRANSPORT • Secure intra venous access • Airway stabilization • Trauma victims – spinal mobilization • Naso gastnc tube • Foley’s catheterization • Chest tube insertion • All drains • -under water seal • -urinary • -wound • Infusion pump & IV drips functioning properly • Soft wrist and leg restraints • Vital signs displayed on monitors • Patient is safely secured on a trolley

  21. DOCUMENTATION • Indication for transport • Patient status during transport vital signs Level of consciousness

  22. MONITORING • Pulse • Oxygen saturation • BP,RR

  23. IN-TRANSIT PROCEDURE • A best route • Lift should be reserved before hand • Status of patient checked at intervals • Continuous monitoring

  24. ARRIVAL PROCEDURE • Assessment • Shifted • Ventilators established • Complete handover • Documentation - patient status with time

  25. CONCLUSION • Systematic approach • Careful planning • Proper use of personnel • Selection and availability of appropriate equipment

  26. Thanks • Sr. Esther Jiju, Ward Sister, MICU

  27. Thank you

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