Critical care clinics
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Critical care clinics · Jul 1992
ReviewTransport of the critically ill patient with upper airway obstruction.
Upper airway obstruction is a life-threatening emergency requiring prompt evaluation and careful intervention. The pathophysiology of upper airway obstruction is reviewed. Assessment techniques and stabilization are discussed with specific attention to intervention and stabilization prior to transport.
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Interhospital transport of children must not be undertaken in a vacuum. Basic medical ethics and federal laws demand that there be some responsibility in providing adequate care during the transport process, and that this care meets or exceeds the level provided by the referring hospital. The care provided must also be appropriate to the severity of illness of the transported children. National guidelines and standards are needed to establish and coordinate a uniform interhospital transport process for critically ill children.
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Critical care clinics · Jul 1992
The nuts and bolts of organizing and initiating a pediatric transport team. The Sutter Memorial experience.
Specialized interfacility transport teams are capable of delivering critical care medicine to the patient at the referring hospital and while en route to the tertiary care center. To do so effectively, however, requires adequate financial and human resources; management of equipment, supplies and personnel; ongoing education for transport team members; and an aggressive quality assurance program. Team members and team management should always be prepared for worst-case scenarios, and develop a method for problem resolution as troublesome issues arise. The ultimate goal of serving the needs of the critically ill child can be consistently met only if there is a high level of commitment of all involved--from the hospital administrator and medical director to the transport coordinator and team members.
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Critical care clinics · Jul 1992
Review Comparative StudyEvaluation of ground ambulance, rotor-wing, and fixed-wing aircraft services.
It is hoped that this article has offered insightful suggestions and criteria in choosing the most appropriate method to transport patients. Ground ambulances, rotor-wing, and fixed-wing aircraft each have advantages and disadvantages in particular circumstances. The advantages and disadvantages of any mode of transport must be considered to best meet the needs of the patient. ⋯ As Hicks et al said, "early resuscitation and timely transfer of selected patients are critical factors in reducing morbidity and mortality." The future holds many possibilities for enhanced patient transport. Hospitals may be able to use tilt-rotor, vertical landing, fixed-wing aircraft to combine the advantages of helicopter and fixed-wing aircraft. After all, our primary goal is to get the right patient, with the right personnel, to the right place in the right amount of time.
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Intrahospital transport of critically ill patients must be considered as part of the critical care continuum. The level of care provided must be commensurate with the severity of illness. These transfers are intensive in terms of utilization of personnel and resources. Advance preparation and optimal coordination of the transport process go a long way toward safer transfers of the critically ill.