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Be Prepared

Every Wednesday our group of registrars meet for a regular teaching session.  This week I’ve been invited to speak on my experiences with patient transport and so, in the spirit of #FOAMed, I have converted my opening talk into a short video that highlights what I feel is the key point of patient packaging – preparedness.

The rule in retrieval medicine is that “If it can go wrong, it will” and so one needs to be prepared.  Unless you are aware of what may go wrong it is very difficult to be prepared to deal with it.  By sharing experiences and telling stories, not just of our successes but of our failures too, we can learn from each other.

 

Be Prepared – Safe Intra-Hospital Transfer of the Critically Ill Patient from Andrew Tagg on Vimeo.

After this brief introduction I am going to run through four retrieval scenarios that they may be faced with. In each case they will assume the role of  the most senior doctor present.  They are all based on real-life challenges – the aim being that sharing my experiences will make them better.

 

The scenarios are:

A) Multiple stab wounds to the neck that needs to transferred to the local trauma centre

B) The elderly gent that is doing just fine on BiPAP but needs to be moved 20km down the road as he is too sick for the ward

C) The intubated, septic patient on multiple pressors that needs to go to ICU

D) The massive haematemesis that is more than meets the eye.

 

We have all had to deal with challenging cases and challenging people.  In our world of checklists and Standard Operating Procedures you might be forgiven for thinking that there is only one way of doing things.  The retrievalist is nothing if not flexible.

The most recent iteration of the Joint College guidelines on the Safe Transfer of the Critically Ill Patient (complete with typo on the opening page) can be found here.

 

Peer reviewed by Minh Le Cong and Yen Chow 22nd April 2014

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