Page 104 - Hall et al (2015) Principles of Critical Care-McGraw-Hill

72 PART 1: An Overview of the Approach to and Organization of Critical Care

TABLE 11-2 Preparing the Patient (Continued) TABLE 11-2 Preparing the Patient (Continued)
Cardiovascular Neurological
Check Check
Hemodynamic parameters Level of consciousness, Glasgow coma scale score
Cardiac output studies Pupil size and reactivity
Fluid requirements, balance, and urine output Analgesia and sedation requirements
Intravenous/intra-arterial lines are patent, functioning and secured firmly with Spinal clearance
antisiphon valves Monitoring
Recent 12 lead electrocardiogram Intracranial pressure if monitored
Inotropic/vasopressor requirements Pupil size and response
Full blood count, coagulation screen, blood group/cross match Potential events
Venous thromboembolism prophylaxis Deteriorating conscious level
Peripheral pulses and circulation Agitation
Monitoring Pain—movement and anxiety contribute to increased pain scores in critically ill patients
Electrocardiogram undergoing transfer, thus pain management should be optimized prior to departure 29,51
Invasive and noninvasive blood pressure Seizures
Central venous pressure Increasing intracranial pressure
If a pulmonary artery (PA) catheter is in situ, PA pressure should be monitored during Deteriorating neurological exam in the context of spinal cord injury
transfer if feasible. If not, the PA catheter should be withdrawn to the right atrium or Drugs
superior vena cava and used to monitor central venous pressure 8
Intubating/anesthetic drugs (see the Respiratory section)
Point-of-care blood testing for long transfers
Short-acting sedatives, eg, benzodiazepine
Urine output—Foley bladder catheter
Rapid-acting anticonvulsant
Potential events
Range of analgesia including paracetamol/acetaminophen and morphine
Acute ischemia
Drugs to reduce intracranial pressure—eg, mannitol
Cardiac arrhythmia
Opiate and benzodiazepine antagonists
Hypotension
Equipment
Hypertension
Intracranial pressure monitor if in situ prior to transfer
Cardiac arrest
Spinal immobilization device
Hemorrhage Ability to raise patient’s head—back rest/adjustable trolley
Peripheral ischemia
Pen torch
Drugs
Scissors
Resuscitation drugs: epinephrine, atropine, amiodarone, and lidocaine Spinal immobilization equipment
Vasopressors
Gastrointestinal
Inotropes
Check
Intravenous fluids
Enteric feeding tube placement—aspirated and placed on free drainage prior to departure
Blood products if likely to be required due to risk of aspiration 52
Anticoagulant Feeding regime
Equipment Bowel motility/absorption
Assorted hypodermic needles and syringes Diarrhea
Infusion pumps Monitoring
Intravenous cannulae 20-14G Gastric aspiration
Tourniquets Potential events
Spare central access monitoring sets Vomiting
Peripheral venous cannulae in various sizes Diarrhea
Giving sets, including those for blood products Drugs
Electrocardiogram leads and electrodes Antiemetic
Defibrillator and adhesive pads Prokinetic
External pacemaker Equipment
Compression stockings Spare nasogastric tube and collection bag
Urinary catheter and collection bag Enteric syringes

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