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ABC of Transfer and Retrieval Medicine

Adam Low (Editor), Jonathan Hulme (Editor)

ISBN: 978-1-118-71963-3 April 2017 BMJ Books 224 Pages


ABC of Transfer and Retrieval Medicine provides the key information required to help health care professionals involved in the movement of critically ill patients to do so safely, correctly and with confidence.

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.

Contributors ix

Preface xiii

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
B. Vadera

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
J. Bingham

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
I. Locke

Section 4 Pharmacology of Transfer Medicine 81

19 Routes of Administration 83
T. Nutbeam and R. Fenwick

20 Pre-hospital Sedation and Analgesia 88
J. Hulme

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
S. Revana

31 Neonatal Medical Transfers 137
Lesley Jackson

32 Paediatric Medical Retrievals 142
S. Ray and E. Polke

33 Paediatric Trauma Retrievals 146
Mary Montgomery

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
H. Simpson

39 Cardiac Transfers 174
C.Westrope and C. Harvey

40 Contagious Patients 178
R. MacDonald

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

Index 203