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124 P R I N C I P L E S A N D P R A C T I C E O F C R I T I C A L C A R E

TABLE 6.15 Standard equipment for transport

Circulatory support Pharmacological
Respiratory support equipment equipment Other equipment agents
● Airway management equipment, ● Monitor/defibrillator/external ● Urinary catheter and bag ● Checked and clearly
including intubation set, range of pacer combined unit ● Nasogastric tube and bag labelled drugs:
endotracheal tubes and laryngeal ● Non-mercury ● Nasal decongestant spray standard resuscitation
mask airways, hand ventilation set sphygmomanometer ● Instruments, sutures, dressings, drugs and those
with PEEP valve and emergency ● IV fluids, pressure infusion set, antiseptic lotions, bandages, specific to the patient’s
surgical airway set infusion pumps slings, splints, tape, cutting condition
● Oxygen, masks, nebuliser ● Arterial cannulae and arterial shears, gloves, protective glasses,
● Pulse oximeter and capnography monitoring device torch
● Sufficient oxygen supply ● Syringes and needles, sharps ● Thermal insulation and
● Suction equipment disposal container temperature monitor
● Portable ventilator with disconnect ● Pericardiocentesis equipment ● Equipment for spinal or limb
and high-pressure alarms immobilisation and bandages
● Pleural drainage equipment ● PPE for transport team

influencing safe transport. 158,161,165,166 Staff should be
BOX 6.6 Key elements of safe transfer 163 trained in the various aspects of patient transport, 158,164,166,167
including competent management and troubleshooting
● Experienced staff of all equipment involved. There is some evidence to
● Appropriate equipment suggest that a designated transport team improves quality
● Full assessment and investigation of care. Team members should be aware of their specific
● Extensive monitoring roles and ensure excellent communication throughout
● Careful stabilisation of patient the transport procedure.
● Reassessment
● Continuing care during transfer Equipment used during patient transport must be robust,
163
● Direct handover lightweight and battery-powered, and must adhere to
● Documentation and audit relevant national manufacturing and safety standards.
Equipment-related complications occur in around a third
of transports. 164,166 All equipment must be adequately
restrained during transport, and must be available con-
Practice tip tinuously to the operator. 158 Oxygen requirements should
be calculated in advance (or it should be established that
Not only appropriate staff but appropriate numbers of staff piped oxygen is available at the destination department)
should participate in the patient transport. A nurse cannot to ensure an adequate supply, both for the journey and
monitor the patient, manage events and push the bed as well. for the duration of the investigation/procedure. Standard
equipment for interhospital transport is identified in
Table 6.15; 158 and while some items may be unnecessary
ESSENTIAL NURSING CARE DURING for all intrahospital transport, Table 6.15 provides a
TRANSPORT useful checklist so that all necessary equipment is taken.
Essential care during transport involves three compo- Additional specialist equipment may be required for
certain patients, such as spare tracheostomy tubes in case
nents: the patient, the personnel and the equipment and of accidental extubation.
monitoring. Importantly, the patient and their family
should be given an explanation of why the transport is Before transport, all equipment should be prepared and
necessary, how long the procedure is expected to take and checked, including the function of visible and audible
that the transport process includes the team accompany- alarms. All non-essential therapy should be discontinued
ing the patient to continue monitoring and provide any temporarily during the transport, such as enteral nutri-
required treatment. tion. Where possible, therapies should be simplified,
such as exchanging chest drainage systems for one-way
Nursing responsibilities during transport of the patient
include all aspects of patient monitoring and comfort. valves, or disconnecting completed infusion administra-
All vital signs and equipment parameters should be moni- tion sets from intravenous lines. The patient’s physical
tored and the equipment should be checked regularly to safety should be maintained and care should be taken
ensure correct functioning. Gas reserves and battery time to ensure that bed rails are used and the patient’s limbs
require vigilant attention. Patient safety is paramount and are secure and not likely to be injured by equipment.
close attention to detail is required. Throughout the trans- All vital monitoring and therapy equipment should be
port, patients should be reassured regarding their condi- transferred to portable equipment, and the patient
tion and the progress of the purpose of the transport. should be stabilised before being moved. If the patient
is being transported for magnetic resonance imaging
The level of experience and specialty of personnel involved (MRI), it is important to ensure that all equipment is
in the transport of critically ill patients are factors compatible.