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
|