ABC of Transfer and Retrieval Medicine
December 2014, ©2014, BMJ Books
Beginning with the practical and clinical considerations to be taken into account during patient transfer and an overview of transfer equipment, it then addresses pharmacological aspects of patient transfer, the roles and responsibilities of the transfer team, and the requirements of neonatal, paediatric and specialist transfers.
Mapped against the syllabus for the Diploma of Retrieval and Transfer Medicine (Royal College of Surgeons of Edinburgh), it has been developed as a core resource for the diploma whilst providing an invaluable resource for any healthcare professional involved in the transfer of critically ill patients including anaesthetists, intensivists, nurses from ICU/ED and paramedics. It also includes frameworks for radiology and arterial blood gas interpretation, guidance on patient triage, transfer checklists and equipment checklists, and a summary of the relevant national guidelines.
From a multidisciplinary international author team, this new addition to the ABC series is a useful resource for all health care professionals involved in the transfer of patients. It is relevant to anaesthetists, intensivists, paramedics, critical care and emergency department nursing staff who are required to take part in intra and inter hospital transfers.
List of Abbreviations xv
1 Introduction 1
A. Low and J. Hulme
SECTION 1 PHYSIOLOGY OF TRANSFER MEDICINE 3
2 Acceleration Deceleration and Vibration 5
M. Sheils and C. Hore
3 Environmental Exposure and Noise 9
P. Paal and M. Helm
4 Altitude Physiology 13
Y. Wimalasena and C. Duncan
SECTION 2 CLINICAL CONSIDERATIONS 19
5 Resuscitation and Stabilisation 21
C. Reid and K. Habig
6 Patient Packaging and Nursing Care 28
C. Small and F. Clarke
7 Mode of Transport 31
A. Cadamy and T. Martin
8 International Repatriations 36
9 Critical Incidents 39
J.M. Droogh and J.G. Zijlstra
SECTION 3 TRANSFER EQUIPMENT 43
10 Electrical Supply and Batteries 45
G. Roberts and J. Hulme
11 Transport Ventilators and Medical Gas Supply 47
12 Monitoring 51
A. Corfield and S. Hearns
13 Drug Delivery 54
J. Cuell and M. McCabe
14 Near Patient Testing and Imaging 58
A. Low and T. Harris
15 Haemorrhage Control and Splinting 63
A. Hughes and A.Weaver
16 Stretchers Incubators and Vacuum Mattresses 70
H. Bawdon and M.Ward
17 Personal Protective Equipment 73
C. Bosanko and S. Hepburn
18 Communication and Navigation 77
SECTION 4 PHARMACOLOGY OF TRANSFER MEDICINE 81
19 Routes of Administration 83
T. Nutbeam and R. Fenwick
20 Pre-hospital Sedation and Analgesia 88
21 Sedation and Neuromuscular Blockers 92
E. Joynes and B. Munford
22 Inotropes and Vasopressors 96
A. Fergusson and R. Tipping
23 Specialist Pharmacology: Haemostatics and Uterotonics 100
P. Morgan and D. Lockey
SECTION 5 THE TRANSFER TEAM 105
24 Managing and Leading a Transfer 107
D. Ellis and S. Mazur
25 Teamwork and Communication 111
C. McQueen and K.Thies
26 Non-technical Skills and Sources of Error 115
C. McQueen and M. Horton
27 Standard Operating Procedures Checklists and Documentation 119
S. Sollid and O. Uleberg
28 Audit Medicolegal and Ethical Aspects of Transfer Medicine 122
G. Evetts S. Cox and R. Tipping
29 Training for Transfers 126
J.Warwick and D. Quayle
SECTION 6 NEONATAL AND PAEDIATRIC TRANSFERS 131
30 Anatomical and Physiological Considerations 133
31 Neonatal Medical Transfers 137
32 Paediatric Medical Retrievals 142|
S. Ray and E. Polke
33 Paediatric Trauma Retrievals 146
34 Additional Considerations 152
H. McNeilly and J. Hegarty
SECTION 7 SPECIALIST TRANSFERS 155
35 Head & Spinal Injuries 157
R. Protheroe and F. Lecky
36 Burns 160
T. Muehlberger M. Büeschges and C. Ottoman
37 Polytrauma and Military Retrievals 164
D. Keene and O. Bartells
38 Obstetric Transfers 169
39 Cardiac Transfers 174
C.Westrope and C. Harvey
40 Contagious Patients 178
41 Bariatric Patients 183
Z. Dempsey and M. Ross
42 Acute Behavioural Disturbances 187
M. Le Cong
43 Considerations Regarding Organ Donation 190
Anders Aneman andWilliam O'Regan
Appendix 1 Framework for Radiology Interpretation 193
Appendix 2 Framework for Interpretation of Arterial Blood Gases 194
Appendix 3 Example of a Triage Sieve 195
Appendix 4 Example of a Transfer Checklist 196
Appendix 5 Example of Equipment Inventory 197
Appendix 6 Summary of useful National Guidelines 201
Adam Low, Specialist Registrar in Anaesthetics, West Midlands Deanery, West Midlands Central Accident Resuscitation & Emergency (CARE) Team, West Midlands Ambulance Service NHS Foundation Trust Medical Emergency Response Incident Team (MERIT), UK; AMREF Flying Doctors, Kenya
Jonathan Hulme, Consultant in Intensive Care Medicine and Anaesthesia, Sandwell and West Birmingham Hospitals NHS Trust; Honorary Senior Clinical Lecturer, University of Birmingham, Birmingham; West Midlands Ambulance Service NHS Foundation Trust Medical Emergency Response Incident Team (MERIT); Medical Director, West Midlands Central Accident Resuscitation & Emergency (CARE) Team; Mercia Accident Rescue Service (MARS) BASICS, UK
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