Transit care medicine—A critical link *

Keeping Patients Safe During Intrahospital Transport

“…23,31 This protocol should address pretransport communication and coordination, equipment, monitoring, documentation, and transport personnel/training. 11,14,32,33 Training should include a "competency-based orientation"…”

“…According to the guidelines, each hospital should have a written protocol for intrahospital transport, 3,7,11,14,23,31,32 developed by a multidisciplinary team 14,23,31 and evaluated by a quality improvement process. 23,31 This protocol should address pretransport communication and coordination, equipment, monitoring, documentation, and transport personnel/training.…”

“…If the patient does not tolerate clamping the ventriculostomy, as evidenced by an increase in ICP, the ventriculostomy should be leveled at ordered height per institutional policy and unclamped to drain. 2 Braxton et al, 8 Warren et al, 14 Stevenson et al, 23 Beninati et al, 26 Torri, 27 Preuss and Wiegand, 28 Australasian College for Emergency Medicine, Australian and New Zealand College of Anaesthetists and Joint Faculty of Intensive Care Medicine, 31 Nagappan, 32 Nagler and Krauss, 47 Hinkelbein et al,…”

Retrieval medicine: a review and guide for UK practitioners. Part 1: Clinical guidelines and evidence base

“…Local training and adherence to local, as well as national, guidelines should go some way to achieving more uniform patterns of care. The concept of ''transit care medicine'' has been suggested previously 34 and is useful when considering this patient group and the variety of skills required to deliver effective transport and ongoing therapeutic interventions. A national reporting system for adverse incidents occurring during transport would go some way in seeing what the situation is nationwide.…”

Guided transfer of critically ill patients

“…We must acknowledge that an alternative explanation for these data is that transfer services have simply become much better at selecting which patients can tolerate interhospital transfer; certainly patient selection can be an important source of bias in many transfer studies [16 ]. But given the high acuity of many patients transferred to referral centers, it seems likely that the proliferation of guidelines for interhospital transfer represents a real accumulation of knowledge about how to safely perform this essential task [17][18][19][20][21][22].…”