Page 512 - Clinical Application of Mechanical Ventilation

478 Chapter 14

patients. When the patients need to go from the intensive care setting to another loca-
tion, some of these resources may not be readily available during transport. For this
reason, a complete transport plan must be developed well in advance. The plan should
include the transport team (e.g., ambulance or flight crew, RT, and nurse), procedure,
and equipment and supplies necessary for a safe and uncomplicated transport.

Indications

The most common indication for intrahospital transport of mechanically ventilated pa-
tients is to acquire diagnostic procedures at a location other than the intensive care set-
ting (e.g., MRI in the radiology department). For interhospital ground or air transport,
it is usually done to acquire tertiary medical care or procedures (e.g., burn care, third-
level nursery) that are only available at the destination facility (Ehrenwerth et al., 1986).
For safety reasons, transport of mechanically ventilated patients must follow a thorough
evaluation of the risk -benefit factor based on the patient’s clinical condition.
Contraindications

Contraindications for transport of mechanically ventilated patients include inabil-
A patient should not be ity to provide adequate oxygenation and ventilation, inability to maintain acceptable
transported when the hemo-
dynamic status is deteriorat- hemodynamic status, inability to provide adequate airway control or cardiopulmonary
ing or unstable. monitoring, and lack of trained transport team members (Weg et al., 1989). A patient

should not be transported when the hemodynamic status is deteriorating or unstable.
Equipment and Supplies

The availability of medical equipment and supplies during transport is rather lim-
ited, and sometimes they may not be accessible. This is mainly due to limited space
in the transport unit and partly due to unforeseen circumstances. This problem
may be minimized by developing and using a list of equipment and supplies based
on the type of transport and the characteristics of the patients. Table 14-4 shows a
sample of essential respiratory care equipment and supplies for a typical transport.

Types of Transport

Transport of patients who are being mechanically ventilated imposes many chal-
lenges, including: use of transport ventilator and emergency supplies, availability
transport ventilator: A
mechanical ventilator capable of of a team of trained personnel, and distance of transport (Reynolds et al., 1992).
operation without piped-in gas When transporting a patient away from a medical care facility (interhospital trans-
sources or electrical connection.
port), the transport team must decide which mode of transportation is most suit-
able. One main deciding factor is the distance between the departing facility and the
interhospital transport: Moving destination facility. Four modes of transportation are available: ground ambulance,
a patient between two hospitals.
helicopter, propeller-drive aircraft, and jet (Rouse et al., 1992). There are advantages
and disadvantages associated with each mode of transportation (Table 14-5).
Intrahospital Transport. Transport of patients within the hospital is done for the pa-
tient to receive advanced diagnostic procedures that require use of bulky or station-
ary equipment (e.g., CAT scan, MRI scan). For patients who require ventilatory

Copyright 2013 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part. Due to electronic rights, some third party content may be suppressed from the eBook and/or eChapter(s).
Editorial review has deemed that any suppressed content does not materially affect the overall learning experience. Cengage Learning reserves the right to remove additional content at any time if subsequent rights restrictions require it.