Transfer of Critically ill

Usually these patients are ventilated and on cardiovascular support. It involves lot of gadget to transfer these patients.

For an uneventful transfer be it intra- or inter hospital transfer the following tips will help:

1. Adequate oxygen supply - twice that required for the journey
2. Fully charged ventilator
3. Fully charged monitor - minimum monitoring should include ECG, SPO2, BP either IBP/NIBP, ETCO2.
4. Adequate nitric oxide if used. Proper connectors should be ready.
5. Emergency Drugs- Atropine, Adrenaline(1/1000 and 1/10000 dilutions), metaraminol(1mg/ml in 10 ml), saline flushes should be present atleast.
6. Anaesthetic drugs - Muscle relaxant(paralyse a ventilated patient before transfer), Fentanyl/Alfentanil or morphine infusion(if already on that in ICU).
7. Fluids - Colloids - Gelofusine, hetastarch, blood(if low Hb)
8. Minimise things to be transferred - like KCl, Actrapid or frusemide infusion.
9. Adequate staff to transfer.