Paediatric and neonatal critical care transport PDF
Preview Paediatric and neonatal critical care transport
xidneppA:1 lacipyrte lavrsmroeifT 721 tisnarT nI tnempiuqE &:gnirotinom kciT yna fo eseht smeti desu gnirudrefsnart :GCE rotalitne:V :PACNI APC :VMI/PA gnorPPC :tnev-dimuH :negyxO retemixo-esluP: rA lairet:PB pamaniD:PB O resylana: 2 .pme:Teborp :pmeTeruS GBA:)lac ANIT on( ANITOp( :)lac ANITOCp( :)lac 2 2 elcihe:edoc-llacV ybesarG:pmup metsyS 1 ro:2 cirtiN:edixO .V.I dna.A.I sdiulf dna de sgurdriuqe nir.tisnart esaelP:kcit ecnanetniaMsdiulf rehtOsnoisufni %01esoculG %01 esoculG dna %81•0enilaS desinirapeHenilaS enihpromaiD malozadiM muidoSetanobracib %51esoculG %4 esoculG dna %81•0enilaS %9•0enilaS enimatuboD enihproM enilozaloT %5esoculG nimublA%5•4 enimapoD muinorucnaP rehtO: muirucartA enirhpenipE000,01:1 nilcycatsorP doolB muisengaMetahpluS nidnalgatsorP rehtO: rotaripseR yroppus:t ratS t fo:yenruoj :edoM :PIP :PAPC/PEEP :MPB OiF : 2 dnE fo:yenruoj :edoM :PIP :PAPC/PEEP :MPB OiF : 2 mumixaM:sgnittes :edoM :PIP :PAPC/PEEP :MPB OiF : 2 :smelborP diD yna tnempiuqe,liaf ro e?smelbovigrp e e y smelborerehtnarp htiw eht ybabW ni?tisnart :ne noitcAkat esaelP enohp rehto stinu rof lanif serocs firasseceny :TNAT kcehCROPMI siht mrof si e etelpmocro gniliffeb (cid:150) a kramrev nix yeob AJL 0100 821 rtaidea ciP dna latanoenrc laciti eropsnaracrtt CIRT EVISNETNIC ERAAIDEA (cid:150)RETSECIELP NOITA LATNEMUCODVEIRTER ropmI:tnat lliF ni siht tnemucod sa yletelpmoc dna ylbigel sa!elbissop ENOHPELETCLLA de llaCyviecebr :emaN :etaD / / :emiT nosaeR rof:tcatnoc ]refsnarT[ ecivdA[]ylno gnirrefeR rotcod dna:edarg peelB:on gnirrefeR:tnatlusnoc :erawA ]seY[]oN[ gnirrefeR:latipsoh etaD fo noissimda gnirre otfe:latipsohr / / :emiT noitacoL fo:tneitap rehtO[]UCIP[]UNN[]UTI[]E&A[ ] latipsoH enohpeletrebmun: :noisnetxE ATA TNEITDAP :emaN :xeS ]F[]M[ :B.O.D :egA :thgieW gK lanoisiv:sisongaidorP feirBrotsih y gnidulcni dibromerp:snoitidnoc xidneppA:1 lacipyrte lavrsmroeifT 921 LA T GNIRREFERTIPSOHA SUTA TNERRUCTS detabutnI ]seY[ ]oN[ fI:detabutni :emiT fI ton:detabutni :detalitneV ]deggabdnaH[]oN[]seY[ pseR:etar nim/ rotalitne:V pseR:ssertsid ]diM[]enoN[ :TTEezis htgnel ]N[]O[ ]ereveS[]etaredoM[ etaR nim/ VT lm VM L rodirtS: ]N[]Y[ :ezeehW ]N[]Y[ PIP Hmc O PEEP Hmc O deddA:sdnuos 2 2 OI[FiO OaP/PAMx)%( ])gHmm( riArtne:y ]lamronbA[]lamroN[ 2 2 ON)mpp( ]L<R[]L>R[]L=R[ RXC :RXC OaS% in FiO OaS% in FiO 2 2 2 2 :esluP nim/ :PB / gHmm rallipaC y:llifer sdnoces Colour: ]kniP[ ]elaP[]desonayC[ :erutarepmeT :eroC :larehpireP C(cid:176) raeH t:sdnuos ]lamroN[ ]lamronbA[ :pollaG ]seY[ ]oN[ rumruM: ]seY[ ]oN[ reviL: smc :neelpS smc enirU:tuptuo ruoh/gk/lm lev foeL:ssensuoicsnoc relA[]t :slipuP :thgiR mm ]dexiF[]hsiggulS[]ksirB[ sdnopseR[ ot]eciov :tfeL mm ]dexiF[]hsiggulS[]ksirB[ sdnopseR[ ot]niap :idnuF ]ssenevisnopsernU[ desylaraP[ dna]detades :msignineM ]seY[ ]oN[ :hsaR ST TSOM TNECER DOOLBLUSER rtsimehcoiBy tluseR doolBsaG tluseR esoculG Hp muidoS OCP 2 muissatoP Op OiF/ / 2 2 aerU etanobraciB eninitaerC esaBticifed muiclaC golotameaHy Bilirubin Hb nimublA CCW steletalP RNI TTPA 031 rtaidea ciP dna latanoenrc laciti eropsnaracrtt YLA NEVIG YB GNIRREFERDAERLATIPSOH TNEMTAERT :seniL larehpire suonePv:senil lartneC suonev:enil ]seY[ ]oN[ etiS[ ] rA lairet:senil ]seY[ ]oN[ sdiulF:nevig diolloC gk/lm PFF gk/lm doolB gk/lm rehtO gk/lm seportonI / emaN etar nim/gk/gcm srotalidosaV emaN etar nim/gk/gcm emaN etar nim/gk/gcm ecnanetniaMdiulf epyT etar yad/gk/lm = rh/lm ]lamroN[ tcirtseR[ot ]% esaercnI[ot ]% sgurDnevig emaN(,esod,)emit RO HTIW GNIRREFERTCOD TSILKCEHC se mae fvIirra detpecca rof refsnart ksa rof ehTt gniwollof ot eb e enod lavroeirteRfeb [ ] O VIWT senildedeen [ ] potS laro ro GN,gnideefresni t TGN fignitabutni [ ] yfitoN stnerap forefsnart [ ] ,E&A ypocotohP lacidem dnasy gnis rwuon sbo/setonarXrrob/y dnapoc lanoitid stseuqedA rorf OMCE:stneitap [ ] lluF gnittolcneercs [ ] daeH nacs dna(raeh t nacs fi)elbissop [ ] ssorC hctam rof:doolb lm01 dettolc elpmas morf rehtom fi()etanoen 1 tluda tinu )lm003( de foslleckcap SLIA MAETTED REFSNART :sesruN 1. 2. :srotcoD 1. 2. SEMIT REFSNART emiT:de ecnalubmakoob emiT fo eraped morutrfretsecieL: emiT fo lavirra gnirre tafe:latipsohr emiT fo gnirre eraped mofe:latipsohrutrfr emiT fo lavirra taretsecieL: xidneppA:1 lacipyrte lavrsmroeifT 131 MAET LA LA FOVEIRTERVIRRA NOITIDNOC NO )maeT tnemssessA( yb lacideM detabutnI ]seY[ ]oN[ fI:detabutni :emiT fI ton:detabutni :detalitneV ]deggabdnaH[]oN[]seY[ pseR:etar nim/ rotalitne:V pseR:ssertsid ]diM[]enoN[ :TTEezis htgnel ]N[]O[ ]ereveS[]etaredoM[ etaR nim/ VT lm VM L rodirtS: ]Y[ ]N[ :ezeehW ]Y[ ]N[ PIP Hmc O PEEP Hmc O deddA:sdnuos 2 2 OI[FiO OaP/PAMx)%( ])gHmm( riArtne:y ]lamronbA[]lamroN[ 2 2 ON)mpp( ]L<R[]L>R[]L=R[ RXC :RXC OaS% in FiO OaS% in FiO 2 2 2 2 :esluP nim/ :PB gHmm rallipaC y:llifer sdnoces Colour: ]kniP[ ]elaP[]desonayC[ :erutarepmeT :eroC :larehpireP C(cid:176) raeH t:sdnuos ]lamroN[ ]lamronbA[ :pollaG ]seY[ ]oN[ rumruM: ]seY[ ]oN[ reviL: smc :neelpS smc enirU:tuptuo ruoh/gk/lm lev foeL:ssensuoicsnoc relA[]t :slipuP :thgiR mm ]dexiF[]hsiggulS[]ksirB[ sdnopseR[ ot]eciov :tfeL mm ]dexiF[]hsiggulS[]ksirB[ sdnopseR[ ot]niap :idnuF ]ssenevisnopsernU[ desylaraP[ dna]detades :msignineM ]seY[ ]oN[ rehtO:sgnidnif srotcaD:eman :erutangiS 231 rtaidea ciP dna latanoenrc laciti eropsnaracrtt MAET REFSNART NEKA YBT SNOITCA :yawriA ebudegnahcT/detabutnI ]oN[]seY[ :emiT :TTE :eziS :htgneL ]larO[]lasaN[ sgurD desu rof:noitabutni rotalitneV FiO : :PIP :PEEP 2 :sgnittes :etaR iT: :eT :sseccA larehpireealuPnnac :gnitixe :TT tup ni yb lartneC suonev:enil :gnitixe :TT tup ni yb rA lairet:enil :gnitixe :TT tup ni yb ranirU yretehtac: ]tneserP[ ]dessaP[ ]degnahC[ ]enoN[ GN:ebut ]tneserP[ ]dessaP[ ]degnahC[ ]enoN[ :scitoibitnA :emiT rehtO:stnemtaert ERUTTSILKCEHCRAPED-ERP SUTA LACINILCTS yawriA ye,rucesawriAde y TTElexifruces [ ] noitalitneV , noitalitnerotcafsitasyV doolB,sesagy tsehCarX [ ] noitalucriC ralucsa etauqedA,sepo sseccartoni/sdiulferucesV [ ] goloyrueN se,delloruzieSrtnoc yletauqedAdesylarap/detades [ ] laneR ranirU y retehtac ni ecalpde firiuqer [ ] TIG GN ebut dessap,de firiuqer doolb ragusrotcafsitasy [ ] erutarepmeT de,rusaeM dnarotcafsitasy etauqedAgnimraw [ ] NOITATNEMUCOD ]setoN[ ]retteL[ refsnar]tnesnocT[ ]syarX[ SEILPPUS ]negyxO[ ]sdiulF[ ]rewoP[ NOITACINUMMOC tneraP[]stne egakcap]neraP[vig YELLORT NO ]ksaM[ suseR[]sgurd ehtaerbeR[]gab ]epocsohtetS[ SGAB sgurD[ egdirF[]xob]sgurd neerG/deR[]gab ENOHPELET UCIP[ retsecieL]deifiton STNEITA OMCEP ]doolB[ OMCE[]tnesnoC xidneppA:1 lacipyrte lavrsmroeifT 331 noitaulav gnisruN dnae seton gnirudrefsnart: sesruN eman dna:edarg :erutangiS LA KCB NIARETSECIELVIRRA NOITIDNOC NO :erutarepmeT :eroC C(cid:176) :larehpireP C(cid:176) noitalitneV FiO : :PIP :PEEP 2 :etaR iT: :eT OpS OCte 2 2 :scimanydomeaH :esluP :PB p:llifeaCr golo:yrueN :SCG :slipuP DRASTNEVEWOTNU TNEITAP TNEMPIUQE ekawA [ ] noitarutaseD [ ] rotalitneeruliafV [ ] rotinoMeruliaf [ ] noisnetopyH [ ] esiR niOCte [ ] .fnI pmuperuliaf [ ] ssoL foVI [ ] 2 repyHnoisnet [ ] noitabutxE [ ] deliaF sagylppus [ ] noitacinummoC [ ] aidracydarB [ ] de TTEkcolb [ ] ecnalubmAborp [ ] aidracyhcaT [ ] lipuPsegnahc [ ] gaB tondeppiuqe [ ] rehtO [ ] :yficepS feirB sliated:tne fove tnedicnI mrofdetelpmoc seY [ ] oN [ ] xidneppA:2 laitnessEsnoitauqe dnaseriomØm-edia Estimating weight noinApag = aN( + +K + ) − LC( − +OCH −) 3 thgie)gk(W = ega( + )4 × 2 ytilalomsO)mures( = 2( × aN + ) +esoculg+aeru Blood gas unit conversion Gas requirements for transfer o trevnoc gHmm otT ,aPk ylpitlum yb .7131•0 ehT negyxo stnemeriuqer ni( )sertil fo atneitap o trevnoc aPk otT ,gHmm edivid yb.7131•0 nac eb detamitse morf eht:alumrof wolF dereviled)nim/l( × iF O × yenruojemit 2 Respiratory support indices )nim( × 2 noitanegyxO xedni)IO( = naem yawriaerusserp woH gnol a rednilyc ylppus lliw tsal yameb × iF O /)%( PaO ni.gHmm detamitse morf eht:alumrof 2 2 noitalitneV xedni)IV( = PaOC × yrotaripseretar rednilyC stnetnoc sag/)sertil( noitpmusnoc 2 × kaep yrotaripsni0001/erusserp )nim/sertil( n eayreauMwsrsiearp = PIP(( × T ) +PEEP( × T /)) etamixorppa( rednilyc stnetnoc nehw lluf era I e T( +T ) detnirp no eht)rednilyc I e erehwPIP = kaep yrotaripsnierusserp PEEP = evitisop dne yrotaripxeerusserp Endotracheal tube sizes T = yrotaripsniemit I hguoR ediug rof tnafni TTE lanretni retemaid − T = yrotaripxeemit e 01/noitatseg osla( ees elbat .)woleb redlOdlihc TTE:sezis Other physiological measures :retemaiD )4/ega( +4 htgneL laro( :)TTE )2/ega( +21 negyxO tnetnoc nidoolb = 63•1 × bH × negyxo htgneL lasan( :)TTE )4/ega( +51 noitarutas deriseD cilotsys doolberusserp = 08 + ega( × )2 revo( 2 sraey fo)ega lacarO laehrtodnesebut lasaNsebut thgie)g(W TTEretemaid tuChtgnel htgneL taspil htgneL taseran 005 5•2 5•6 6 5•7 0001 5•2 7 5•6 5•8 0051 0•3(cid:150)5•2 5•7 7 9 0002 0•3 8 5•7 5•9 0052 0•3 5•8 8 01 0003 5•3 5•9 9 5•01 0053 5•3 5•01 01 5•11 Selected references and bibliography General Leslie A, Bose C. Nurse-led neonatal transport. Semin Neonatol1999;4:265–71. Logan S. Evaluation of specialist paediatric retrieval Advanced Life Support Group. Advanced Paediatric teams. Br Med J1995;311:839. Life Support. London: BMJ Publishing Group, 1997. Lovell MA, Mudaliar MY, Klineberg PL. Intrahospital Advanced Life Support Group. Safe Transfer and transport of critically ill patients: complications and Retrieval—The Practical Approach. London: BMJ difficulties. Anaesth Intens Care 2001;29:400–5. Publishing Group, 2002. Macnab AJ. Optimal escort for inter-hospital transport Booth P, Madar J, Skeoch C. The Handbook of Neonatal of pediatric emergencies. J Trauma1991;31:205–9. Transport. Aberdeen: Scottish Neonatal Consultants’ Macrae DJ. Paediatric intensive care transport. Arch Dis Group, 1996. Child1994;71:175–8. British Paediatric Association. The Care of Critically Ill Paediatric Intensive Care Society. Standards for Children. Report of a Multidisciplinary Working Paediatric Intensive Care Including Standards of Party on Paediatric Intensive Care. London: British Practice for the Transportation of the Critically Ill Paediatric Association, 1993. Child. Paediatric Intensive Care Society, 1996: Glasgow JFT, Graham HK. Management of Injuries in Bishop’s Stortford, UK: Saldatore. Children. London: BMJ Publishing Group, 1997. Pon S, Notterman DA. The organisation of a pediatric Jaimovich DG, Vidyasagar D (eds). Handbook of critical care transport program. Pediatr Clin North Pediatric and Neonatal Transport Medicine. Am1993;40:241–61. Philadelphia: Hanley and Belfus, 1996. Sharples PM. Avoidable factors contributing to death of Macnab AJ, Smart P. Lightweight monitoring children with head injury. Br Med J1990:300:87–91. equipment for pediatric transport. Intens Ther Clin Monit1990;(May/June):92–6. Macrae DJ. Paediatric intensive care transport. Arch Dis Child1994;71:175–8. Transport physiology Morton NS, Pollack MM, Wallace PGM (eds). Stabilisation and Transport of the Critically Ill. Gajendragadkar G, Boyd JA, Potter DW, Mellen BG, Edinburgh: Churchill Livingstone, 1997. Hahn GD, Shenai JP. Mechanical vibration in Resuscitation Council (UK). Newborn Life Support neonatal transport: a randomized study of different Provider Course Manual. London: Resuscitation mattresses. J Perinatol2000;20:307–10. Council, 2001. Lawler PG. Transfer of critically ill patients: Part 1— Resuscitation Council (UK). Resuscitation Guidelines physiological concepts. Care Crit Ill2000;16:61–5. 2000. London: Resuscitation Council, 2000. Lawler PG. Transfer of critically ill patients: Part 2— preparation for transfer. Care Crit Ill2000;16:94–7. Miller C. The physiologic effects of air transport on the neonate. Neonatal Network1994;13:7–10. Principles of safe transport Sherwood HB, Donze A, Giebe J. Mechanical vibration in ambulance transport. Clin Studies 1994;23:457–63. Towers CV, Bonebrake R, Padilla G, Rumney P. The Anonymous. Guidelines for the transfer of critically ill effect of transport on the rate of severe patients. Crit Care Med1993;21:931–7. intraventricular hemorrhage in very low birth weight Barry PW, Ralston C. Adverse events occurring during infants. Obstet Gynecol2000;95:291–5. interhospital transfer of the critically ill. Arch Dis Wright MS, Bose CL, Stiles AD. The incidence and Child 1994;71:8–11. effects of motion sickness among medical attendants Britto J, Nadel S, Levin M, Habibi P. Mobile paediatric during transport. J Emerg Med1995;13:15–20. intensive care: the ethos of transferring critically ill children. Care Crit Ill 1995;11:235–8. Edge WE, Kanter RK, Weigle CGM, Walsh RF. Reduction in morbidity in inter-hospital transport by The ambulance environment specialized pediatric staff. Crit Care Med 1994;22: 1186–91. Intensive Care Society. Guidelines for the Transport of Auerbach P, Morris J, Phillips J, et al. An analysis of the Critically Ill Adult. London: Intensive Care ambulance accidents in Tennessee. JAMA 1987;258: Society, 1997. 487–90. Hunt RC, Brown LH, Cabinum ES, et al. Is ambulance Lacher ME, Bausher JC. Lights and siren in pediatric transport time with lights and sirens faster than that 911 ambulance transports: are they being misused? without? Ann Emerg Med 1995;25:507–11. Ann Emerg Med 1997;29:223–7. 136 Paediatric and neonatal critical care transport Little JW. Ambulance transport for the newborn. Semin Equipment and monitoring Neonatol1999;4:247–51. Madar RJ, Milligan DWA. Neonatal transport: safety Nielson H, Jung A, Atherton S. Evaluation of the Porta- and security. Arch Dis Child1994;71:F147–8. Warm Mattress as a source of heat for neonatal Medical Devices Agency. Transport of Neonates in transport. Pediatrics1976;58:500–4. Ambulances (TINA). London: Department of Health, O’Connor T, Grueber R. Transcutaneous measurement 1995. of carbon dioxide tension during long-distance transport of neonates receiving mechanical ventilation. J Perinatol1998;18:189–92. Vohra S, Frent G, Campbell V, Abbott M, Whyte R. Equipment and monitoring Effect of polyethylene occlusive skin wrapping on heat loss in VLBW infants at delivery: a randomized Brown L, Gough JE, Bryan-Berg D, Hunt R. Assessment trial. J Pediatr 1999;134:547–51. of breath sounds during ambulance transport. Ann Emerg Med 1997;29:228–31. Gebremichael M, Borg U, Habashi NM, et al. Others Interhospital transport of the extremely ill patient: the mobile intensive care unit. Crit Care Med American Academy of Pediatrics. Guidelines for Air 2000;28:79–85. and Ground Transport of Neonatal and Pediatric Palmon SC, Liu M, Moore LE, Kirsch JR. Capnography Patients, 2nd edn. Elk Grove, IL: American Academy facilitates tight control of ventilation during of Pediatrics, 1999. transport. Crit Care Med 1996;24:608–11. Booth P, Madar J, Skeoch C. The Handbook of Neonatal Wilson C, Webber S. Oxygenation saturation during Transport—A Practical Approach for Scotland. transfer. Paediatr Anaesth2002;12:288. Aberdeen: Scottish Neonatal Consultants’ Group, 1996. Hellström-Westas L, Hanseus K, Jögi P, Lundström N-R, Svenningsen N. Long-distance transports of newborn Air transport of critically ill infants with congenital heart disease. Pediatr Cardiol children 2001;22:380–4. Hermansen M, Hasan S, Hoppin J, et al. A validation of a scoring system to evaluate the condition of Aoki BY, McCloskey K. Evaluation, Stabilisation and transported very-low-birth-weight neonates. Am J Transport of the Critically Ill Child. St Louis: Mosby Perinatol1988;5:74–8. Year Book, 1992. Leslie A, Middleton D. Give and take in neonatal Bjerke HS, Barcliff L, Foglia RP. Neonatal survival during transport: communication hazards in handover. a 2500-mile flight. Hawaii Med J1992;51:332–5. J Neonatal Nurs1995;1:27–31. L’Herault J, Petroff L, Jeffrey J. The effectiveness of a thermal mattress in stabilizing and maintaining body temperature during the transport of very Neonatal resuscitation and low-birth weight newborns. Appl Nurs Res 2001;14: stabilisation 210–19. Medical Devices Agency. Transport of Neonates in Ambulances (TINA). London: Department of Health, Utility of trained teams 1995. Stephenson TJ, Marlow N, Watkin S, Grant J. Pocket Chance G, Matthew J, Gash J, et al. Neonatal transport: Neonatology. Edinburgh: Churchill Livingstone, a controlled study of skilled assistance. J Pediatr 2000. 1978;93:662–6. Cook L, Kattwinkel J. A prospective study of nurse- supervised versus physician-supervised neonatal Management of the airway transports. J Obstet Gynecol Neonatal Nurs 1983;12: 371–6. and breathing Hood J, Cross A, Hulka B, et al. Effectiveness of the neonatal transport team. Crit Care Med 1983;11: 419–23. Adams K, Scott R, Perkin RM, Langga L. Comparison of Leslie A, Bose C. Nurse-led neonatal transport. Semin intubation skills between interfacility transport team Neonatol1999;4:265–71. members. Pediatr Emerg Care2000;16(1):5–8. Leslie A, Stephenson T. Audit of neonatal intensive Dockery WK, Futterman C, Keller SR, Sheridan MJ, care transport. Arch Dis Child1994;71:F61–6. Akl BF. A comparison of manual and mechanical Leslie A, Stephenson T. Audit of neonatal intensive ventilation during pediatric transport. Crit Care Med care transport—closing the loop. Acta Paediatr 1999;27:802–6. 1997;86:1253–6. Orf J, Thomas SH, Ahmed W, et al. Appropriateness of Leslie A, Stephenson T. Neonatal transfers by advanced endotracheal tube size and insertion depth in neonatal nurse practitioners and paediatric registrars. children undergoing air medical transport. Pediatr Arch Dis Child2003 (in press). Emerg Care2000;16:321–7.
The list of books you might like
