The Challenge of Aero-medical Critical Care Transport. Focus on critical cases air-ambulance only

In-flight

8,000 Ft.

Logistics of intrahospital transfers Is the transfer absolutely necessary? What are the benefits of transferring the patient? What are the risks of transfer? Where us the transfer to and what is the most reliable and expeditious rout? When should the transfer occur? Which staff should be undertaking the transfer?

Logistics of intrahospital transfers Which preparations of the patient are necessary, and are there any additional special precautions? What equipment is required for the transfer? Is the equipment available and ready to use? What else needs to be taken on the transfer (e.g. transfer documentation, case notes, X- rays, and investigation request forms)?

Checklists Checklist for equipment. Checklist for team preparation. Checklist for patient preparation. Personal checklist.

Is your equipment ready for transfer? Transfer trolley available? Cylinder oxygen supplies full and functional? Syringe drivers and infusion pumps fully charged? Transfer backpack fully equipped with ABC equipment? Check laryngoscope and carry spare batteries?

Is your equipment ready for transfer? Check patient s treatment chart? Appropriate drugs and infusions prepared? Resuscitation drugs available? Anaesthetic drugs available? Refrigerator drugs still usable? Transport ventilator with filter functional? Multi-modality monitor fully charged and functional?

Is your equipment ready for transfer? Transducer leads, oximeter finger probe and BP cuff available? End-tidal CO 2 probe available? Suction unit functional? Defibrillator operational? Warming blanket needed? Transfer documentation form commenced? Anything else we might need or anything missing?

Is the team ready for transfer? Does the transfer team have the appropriate expertise? Do they have enough knowledge of the location and the case? Is the patient stable?(pre-transfer vital signs and arterial blood gases if appropriate) Are case notes, X-ray films, laboratory results and request forms collected?

Is the team ready for transfer? Has the receiving department been informed about imminent departure and estimated time of arrival? Has the porter been informed?

Is the patient ready for transfer? Is the patient informed about the planned transfer? Are the relatives informed and aware of the transfer? Have drugs, pumps and lines been rationalized and secured? Are intubation and ventilation required? Are sedation, analgesia and neuromuscular block adequate?

Is the patient ready for transfer? Is the airway secure? Is the patient breathing of O 2 and CO 2 (PO 2 and PCO 2 ) appropriate? Are chest drains working appropriately? Any evidence of overt or occult bleeding? Is intravenous access secure and adequate? Is the patient appropriately resuscitated and perfused?

Is the patient ready for transfer? Is the urine output adequate? Is the patient haemodynamically stable? What is the current GCS or sedation level? What is the current pupillary response? Are there any focal neurological signs? Is the patient fitting? What is the patient s core temperature prior to transfer?

Am I ready for transfer? Appropriate and warm clothing? Spare cash? Mobile telephone? Telephone numbers of departure and destination hospitals? Fed, watered and toileted?

Am I ready for transfer? Notify hospital switchboard and interested parties of departure? Am I happy with myself, my team, my transport and my patient?

Mode of Aeromedical Transportations Fixed Wing Commercial Flight Charter Flight Helicopter (HEMS)

Air Ambulance Pressurization

Air Ambulance Unpressurization

Air Ambulance Air Taxi

Stretcher in Air Ambulance

Oxygen and Power Supply

Prepare for Boarding

Ready for Boarding

Big Body with Fracture Lib

Difficult Critical Case

Did you know how much gas in our stomach?