Patient Transport
Transport may involve * Primary retrieval
Retrieval from scene of injury to a hospital. Requires: * Adequate training * Scene organisation and safety * Mass casualty * Chemical, biological, radiological incidents * Adequate PPE * Adequate fitness * Secondary retrieval
Interhospital transport. Requires: * Sufficient staff
To cover rest, if required. * Consideration of transporting expert assistance to the patient * Intra-hospital transport
Transport of a critically ill patient within the hospital. Requires: * Appropriate nurse * Orderly * Medical practitioner
With appropriate skills.
Modes of Transport
Choice of transportation vehicle will depend on:
- Clinical requirements
- Nature of illness
- Effect of transport method on the illness
- Urgency
- Vehicle availability and suitability
- Safety
- Power and gas supply
- Lighting and climate control
- Restraints for stretcher
- Communication systems
- Suction
- Number of retrieval personnel
- Amount of equipment
- Time taken to transport
- Range and speed of vehicle
- Weather and road conditions
- Staffing training on transport platform
- Conditions at the referring and receiving centre
- Location
- Distance
Risks of Air Transport
Pressure effects:
- Reduced PO2
- Requirement for pressurisation
- Risk of rapid depressurisation
- Expansion of gases
- Air emboli
- ETT cuff
- Middle-ear
- Airfilled spaces
- Under dressing
- DCI risk
Other effects:
- Limb swelling
- Temperature changes
- Humidity changes
- Acceleration, deceleration, turbulence
- Electromagnetic interference
- Motion sickness
Prerequisites
- Secure airway
- IV access
- Secure catheters
- Appropriate monitoring
- Adequate infusion and fluid volume
Equipment
Needs depend on requirements:
- Transport duration
Oxygen and drug supplies should exceed estimated maximum transport time. - Severity of illness