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Considerations regarding patient condition before transport

Considerations regarding patient condition before transport
Patient condition Potential actions to take prior to transport
Hypoxia, frequent desaturation, or hypoventilation in the non-intubated patient
  • Increase oxygen support
  • Assess adequacy of current respiratory support modality
  • Consider endotracheal intubation
Hypoxia, frequent desaturation, or hypoventilation in the intubated patient
  • Identify and treat acute issue/pathology (including pneumothorax, mucus plugging, bronchospasm)
  • Optimize ventilator settings
  • Use adjuncts if necessary (eg, neuromuscular blocking agents, inhaled pulmonary vasodilators)
  • Consider in-situ "test ventilation" with equipment planned for transport for duration of transport prior to actual transport
Need for vasoactive support
  • Assess adequacy of noninvasive versus invasive BP and other hemodynamic monitors
  • Resuscitate prior to transport as circumstances allow. Do not delay emergent procedures to resuscitate a patient.
  • Reassess choice of vasoactive agent(s)
  • Assess adequacy of venous access
Hemodynamic instability
  • Assess risk versus benefit of transport
  • Assess adequacy of planned transport monitoring, current venous access, and vasoactive medication regimen
  • Estimate vasopressor doses (including infusions) and fluid doses that may be necessary during safely transport
  • Ensure appropriate staffing for safe transport
Impaired mental status or cognition
  • Obtain consent for high-risk transport
  • Treat agitation if considered a risk factor for safe transport and patient safety
Acute pain, anxiety, or other discomfort
  • Consider premedication for anxiety and/or pain
  • Ensure adequate analgesia and sedation during transport
Circumstances unique to patient condition (eg, ongoing dialysis, existing surgical drains, endotracheal intubation, need for controlled ventilation, preexisting invasive monitors)
  • Ensure adequate supplies are immediately available during transport
  • Ensure appropriate staffing for safe transport
BP: blood pressure.
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