Advanced Life Support | Airways Ambulance

As much of the equipment as possible should be mounted at or below the level of the patient. In particular, large arrays of vertical drip stands should be avoided. This allows unhindered access to the patient and improves stability of the patients bed.
Ideally all equipment within a transport should be standardized to enable the seamless transfer of patients without, for example, interruption of drug therapy or monitoring due to incompatibility of leads and transducers.
All equipment should be robust, durable and lightweight. Electrical equipment must be designed to function on battery when not plugged into the mains.
Portable monitors should have a clear illuminated display and be capable of displaying EKG, arterial oxygen saturation, non-invasive and invasive blood pressure monitoring, capnography and temperature. Alarms should be visible as well as audible.

The critically ill patient should be accompanied by a minimum of two attendants.
One attendant should be a medical practitioner with appropriate training in intensive care medicine, anesthesia, or other acute specialty.
He or she should be competent in resuscitation, airway care, ventilation and other organ support.
The responsible medical practitioner should be accompanied by another suitably experienced nurse, and or technician.

Prior to departure, transport attendant must familiarize himself with treatment already undertaken and independently assess the patients condition.
In all cases, full clinical details must be obtained, for example, (vent settings, all current meds, latest ABG, CBC, Metabolic panel, CXR) before leaving the unit or OR.
Meticulous resuscitation and stabilization of the patient before transport is the key to avoiding complications during the journey.
The airway should be assessed and if necessary secured and protected.
Intubated patients should normally be paralyzed and sedated.
If a PTX is present or likely, chest drains should be inserted prior to departure.

The standard of care and monitoring during transport should be at least as good as it is in the unit.
Minimum standards required for all patients are appropriate staff, EKG, BP monitoring and arterial oxygen saturation.
ICP monitoring may be required in certain patients.
A written record of pt status, monitored values, treatment given and any other clinically relevant information should be completed after transfer.

All equipment must be securely stowed. Under no circumstances should equipment (e.g. infusion pump) be left on top of the patient. Gas cylinders must properly be placed at the foot of the bed or if necessary, under the bed.
Monitoring must be continuous throughout the transport. All monitors and pumps should be visible to accompanying staff.
Adequately resuscitated and stabilized patients should not normally require dramatic changes to treatment during transport.

Clear records must be maintained of all stages. These should include details of the patients condition prior to and after transport, details of vital signs, clinical events and therapy given during transport.