ABC of Transfer and Retrieval Medicine

Adam Low, Specialist Registrar in Anaesthetics, West Midlands Deanery, West Midlands Central Accident Resuscitation & Emergency (CARE) Team, West Midlands Ambulance Service NHS Foundation Trust Medical Emergency Response Incident Team (MERIT), UK; AMREF Flying Doctors, Kenya Jonathan Hulme, Consultant in Intensive Care Medicine and Anaesthesia, Sandwell and West Birmingham Hospitals NHS Trust; Honorary Senior Clinical Lecturer, University of Birmingham, Birmingham; West Midlands Ambulance Service NHS Foundation Trust Medical Emergency Response Incident Team (MERIT); Medical Director, West Midlands Central Accident Resuscitation & Emergency (CARE) Team; Mercia Accident Rescue Service (MARS) BASICS, UK

• Contributors ixPreface xiiiList of Abbreviations xv1 Introduction 1A. Low and J. HulmeSection 1 Physiology of Transfer Medicine 32 Acceleration Deceleration and Vibration 5M. Sheils and C. Hore3 Environmental Exposure and Noise 9P. Paal and M. Helm4 Altitude Physiology 13Y. Wimalasena and C. DuncanSection 2 Clinical Considerations 195 Resuscitation and Stabilisation 21C. Reid and K. Habig6 Patient Packaging and Nursing Care 28C. Small and F. Clarke7 Mode of Transport 31A. Cadamy and T. Martin8 International Repatriations 36B. Vadera9 Critical Incidents 39J.M. Droogh and J.G. ZijlstraSection 3 Transfer Equipment 4310 Electrical Supply and Batteries 45G. Roberts and J. Hulme11 Transport Ventilators and Medical Gas Supply 47J. Bingham12 Monitoring 51A. Corfield and S. Hearns13 Drug Delivery 54J. Cuell and M. McCabe14 Near Patient Testing and Imaging 58A. Low and T. Harris15 Haemorrhage Control and Splinting 63A. Hughes and A.Weaver16 Stretchers Incubators and Vacuum Mattresses 70H. Bawdon and M.Ward17 Personal Protective Equipment 73C. Bosanko and S. Hepburn18 Communication and Navigation 77I. LockeSection 4 Pharmacology of Transfer Medicine 8119 Routes of Administration 83T. Nutbeam and R. Fenwick20 Pre-hospital Sedation and Analgesia 88J. Hulme21 Sedation and Neuromuscular Blockers 92E. Joynes and B. Munford22 Inotropes and Vasopressors 96A. Fergusson and R. Tipping23 Specialist Pharmacology: Haemostatics and Uterotonics 100P. Morgan and D. LockeySection 5 The Transfer Team 10524 Managing and Leading a Transfer 107D. Ellis and S. Mazur25 Teamwork and Communication 111C. McQueen and K.Thies26 Non-technical Skills and Sources of Error 115C. McQueen and M. Horton27 Standard Operating Procedures Checklists and Documentation 119S. Sollid and O. Uleberg28 Audit Medicolegal and Ethical Aspects of Transfer Medicine 122G. Evetts S. Cox and R. Tipping29 Training for Transfers 126J.Warwick and D. QuayleSection 6 Neonatal and Paediatric Transfers 13130 Anatomical and Physiological Considerations 133S. Revana31 Neonatal Medical Transfers 137Lesley Jackson32 Paediatric Medical Retrievals 142S. Ray and E. Polke33 Paediatric Trauma Retrievals 146Mary Montgomery34 Additional Considerations 152H. McNeilly and J. HegartySection 7 Specialist Transfers 15535 Head & Spinal Injuries 157R. Protheroe and F. Lecky36 Burns 160T. Muehlberger M. Büeschges and C. Ottoman37 Polytrauma and Military Retrievals 164D. Keene and O. Bartells38 Obstetric Transfers 169H. Simpson39 Cardiac Transfers 174C.Westrope and C. Harvey40 Contagious Patients 178R. MacDonald41 Bariatric Patients 183Z. Dempsey and M. Ross42 Acute Behavioural Disturbances 187M. Le Cong43 Considerations Regarding Organ Donation 190Anders Aneman andWilliam O’ReganAppendix 1 Framework for Radiology Interpretation 193Appendix 2 Framework for Interpretation of Arterial Blood Gases 194Appendix 3 Example of a Triage Sieve 195Appendix 4 Example of a Transfer Checklist 196Appendix 5 Example of Equipment Inventory 197Appendix 6 Summary of useful National Guidelines 201Index 203