Critical care transport : Sir Ganga Ram Hospital experience

Sharma, S.C.; Suri, Samir; Pande, Rajesh and Rao, B.K. (2002) Critical care transport : Sir Ganga Ram Hospital experience. In: 6th National Conference of International Trauma Anaesthesia and Critical Care Society, Indian, 30 Aug - 01 Sept 2002, Cochin, India.

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Abstract

Background: Critically ill patients require specialized care at tertiary care centers. Inter hospital transportation of critically ill patients is often deemed unsafe because of instability of vital organ functions. We report our experience of transporting critically ill patients by critical care ambulance and fixed wing aircraft. Setting: The critically ill patients are transferred in a ground critical care ambulance accompanied by a critical care consultant or a registrar, a paramedic trained in critical care and a paramedic assistant. The ambulance is made on Swaraj Mazda chassis and is equipped with Avoid Bird ventilator, Physiocontrol P9 external defibrillator, Multi parameter BPL monitor and a pulse oximeter and infusion pump. The ambulance has spine immobilization kit, inflatable fracture stabilization kt, spinal board, difficult airway kit consisting of LMA's and combitube, cardiac and emergency drugs. To transfer neonatology patients it has a transport incubator (Dragger). The air transport was done in commercial fixed wing aircraft in a space of 7x4 ft created for accommodating the patient. These patients were accompanied by a consultant intensivist. Provision for ventilator, pulse oximeter and emergency drugs were made in the aircraft. Experience: During the last One and half year, 524 critically ill patients were transported, 515 by ground and 9 patients by air. Out of these 49.5% were of Cardiology, 13.5% of Neurology and Neurosurgery, 12.2% Medical, 9% Paediatrics, 8.15% GI Surgery and Gastroenterology, 3.4% of Nephrology, and 3.4% of Surgery. 78 patients were on ventilator and 69 patients needed inotropic support. Adverse events during transport were reported in 29 patients, 4 patients needed resuscitation and there was no mortality. Conclusion: Availability of highly trained staff and adequate equipment can ensure safe transport of critically ill patients.

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