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.
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
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. Bueschges 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
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