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Outline
Intrahospital Transport

Interhospital Transport
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Evaluate the need for transfer

Initial step: benefit vs risk

Careful planning and utilization of equipment

and personnel minimize potential risk

Multidiciplinary team: physician, nurses,

paramedic staff, transport coordinator
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Pretransport coordination
and communication
Physician-to-physician and nurse-to-nurse
communication

Ensure the receiving location

Documentation of medical record (indication

and clinical status)
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Accompanying personnel
Minimum of 2 people, one of them from ICU team

Physician: airway management and ACLS

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Equipment requirement
BP monitor, pulse oxymeter, ventilators,
defibrillators

Basic resuscitation drugs: epinephrine,

norepinephrine, antiarrhythmic drugs,
vasopressin, muscle relaxant, sedatives,
narcotics, analgesics, dextrose, IV fluids

Fully charged battery

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Identifying high-risk patients

The mechanically ventilated patient

High therapeutic injury severity score

Head-injured patients

Hemodynamically unstable patients (with

vasoactive agents)
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Monitoring during transport

ECG

Pulse oxymetry

Periodic measurement of BP, HR, and RR

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Care during transport

Receive the same level of care

Vital signs monitored and recorded in fixed

intervals

Adverse event should be noted

Senior physician available for consult

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Interhospital transport
Patient requires resources

Benefit exceed the efforts

Resuscitation and stabilization before transport

Basic requirements are the same for intra- or

interhospital transport but requires MORE
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Take informed consent

Must be taken from a competent patient,
guardian, legally representative

Risk and benefits of transfer

Documented in the medical record

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Communicate and
coordinate prior to transport
Contact the receiving physician, and explain
clinical condition

The mode of transportation

A copy of medical record, case summary,

laboratory, and radiographic data.
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Decide on accompanying
personnel
Minimum of 2 people
Transport team leader: treating
physician/intensivist/anesthesiologist
Physician with training in airway management
and ACLS
Clear chain of responsibility throughout the
transfer
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Choose transport
equipment and medicines
Equipments Medicines
Bags Adenosine
Masks
Laryngoscope Amiodarone
ETT with stylets Atropine
Magill forceps
Nasopharyngeal airways Dextrose
Oral airways Epinephrine
Nasal cannulae
Oxygen tubing Furosemide
Blood pressure cuffs Lidocaine
ECG monitor/defibrillators
Pulse Oxymeter Nitroglycerine
Stethoscope Norepinephrine
Transport Ventilator
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Choose transport
equipment and medicines
The following medications added immediately
before transport;
Narcotics analgesics
Sedative/hypnotics
Neuromuscular blocking agents
Additional: antiarrhythmic or antibiotics
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Monitoring during
transport
ECG monitoring

Pulse oxymetry

Periodic measurement of BP, HR, RR

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Preparing IV access and

airway before transport
Fluid resuscitation and inotropic support are
initiated

Airway stabilization

Physical restraints

Attention: personnel, equipment, monitoring.

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Check List Preparation

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Documentation
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Documentation
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Thank You