Critical Transfers

Summary

This video demonstrates the critical steps involved in transferring critically ill patients between hospitals. Using the example of a 27-year-old woman with a severe head injury, it emphasizes the importance of meticulous preparation, effective communication, and careful handling of equipment during the transfer. The process includes stabilizing the patient, ensuring all medical equipment is checked, and coordinating with ambulance crews for safe and timely transport. A detailed handover at the receiving hospital ensures continuity of care. The video highlights best practices to ensure patient safety and successful outcomes during these high-stakes medical transfers.

Takeaways

• 😀 Preparation is critical for patient transfers, regardless of distance. A well-prepared transfer ensures safety and effectiveness.
• 😀 The patient's condition should dictate the transfer's management and monitoring, not the fact that they are being transferred.
• 😀 A thorough handover of patient information is essential before transfer to ensure continuity of care.
• 😀 All transfer equipment should be checked against a formal checklist to avoid missing any critical items.
• 😀 Oxygen requirements should be calculated and include 150% of the estimated need for the transfer.
• 😀 Communication with ambulance control is crucial to ensure proper triage and urgent transfer for time-critical cases.
• 😀 Always ensure that the patient and equipment are securely strapped during transport and that access to monitoring equipment is maintained.
• 😀 Ambulance crew should operate the ambulance equipment, and communication with them should be clear and continuous.
• 😀 If any incidents or complications arise during the transfer, such as equipment failures, they should be documented and reviewed later.
• 😀 Upon arrival at the destination, a detailed handover of the patient's condition and treatment history is necessary to ensure the receiving team can take over care.

Q & A

What is the most important principle when transferring critically ill patients?

Preparation is the most important principle. Whether the transfer is 100 yards or 100 miles, preparation must be thorough to ensure the patient’s safety and the success of the transfer.

What are the key considerations for the management of critically ill patients during transfer?

Key considerations include maintaining oxygenation, controlling carbon dioxide levels, monitoring mean arterial pressure, using appropriate access for central venous catheters, and keeping the head elevated to reduce intracranial pressure.

What is the recommended time frame for surgery following an extra dural hematoma?

The recommended time frame for surgery is within 4 hours of the initial injury to improve the patient's chances of a better outcome.

What is the role of a comprehensive handover in the transfer process?

A comprehensive handover ensures that the escorting team is fully briefed on the patient's condition, history, and the management steps taken before transfer, as well as any specific equipment or monitoring needs.

Why should a dedicated transfer form be used?

A dedicated transfer form ensures that all necessary documentation is collected and reviewed, which helps to avoid omissions or errors during the transfer.

What should be checked before the patient is transferred to the ambulance?

The transfer bag and equipment should be checked against a checklist, ensuring that all necessary items, including drugs, oxygen, and monitoring devices, are in place and functional.

Why is the correct terminology important when contacting ambulance control?

Correct terminology is important because it ensures that the ambulance crew understands the urgency of the transfer. For critical transfers, such as neurosurgical emergencies, the ambulance should arrive within 15 minutes.

What is the procedure for securing the patient in the ambulance?

Once the patient is transferred onto the ambulance trolley, the monitoring equipment should be arranged so that it is easily accessible, and the patient should be secured against the wall. The crew should perform a final check to ensure everything is in place.

What are the main considerations when driving an ambulance during a critical transfer?

Driving should be steady with minimal acceleration or braking. Speeding can risk the safety of the patient, the medical team, and the public. It is crucial to prioritize the stability and comfort of the patient during transport.

How should incidents during the transfer be handled?

Any incidents during the transfer should be immediately communicated to the ambulance crew, and the details should be documented and submitted for review to ensure proper governance and response to any issues that arise.

What is the process once the patient reaches the receiving hospital?

Upon arrival, a thorough handover should be made to the receiving team, ensuring all relevant information is communicated, including the patient's history, condition during transfer, and any changes observed. The patient remains the responsibility of the escorting team until the receiving team formally accepts them.