Transport of Critically Ill Patients

Transporting patients entails risk. It requires good communication, planning and appropriate staffing. Any patient who requires transportation must be stabilised before departure. As a general principle, patients should be transported only if they are going to a facility that can provide a higher level of care.

Principles of Safe Transfer

Planning and Preparation

Includes consideration of:

• The type of transport (car, 4WD, boat etc.)
• The staff to accompany the patient
• The equipment and supplies required during the journey for routine and emergency treatment
  • Plan this, and think about problems which could arise, using ABCDE
• Potential complications
• The monitoring and final packaging of the patient

Communication

Effective communication is essential with:

• The receiving centre
• The transport service
• Escorting staff
• The patient and relatives

Stabilisation

Effective stabilisation requires:

• Prompt initial resuscitation
• Control of haemorrhage and maintenance of the circulation
• Immobilisation of fractures
• Analgesia

Reassessment

Remember: if the patient deteriorates, re-evaluate with a primary survey, checking and treating life-threatening conditions, then make a careful assessment focussing on the affected system.

Note: Be prepared: if anything can go wrong it will, and at the worst possible time.