Traveling in hospital with the patient

  1. 0 Any tips on how to make traveling to CT scan/IR/Nuclear Medicine within the hospital with an ICU patient who's vented and on all sorts of gtts? I have been a nurse for 1 yr, and have been on nights. I am switching to day shift and I am having some major anxiety thinking about traveling with these patients....
  2. Visit  HeaFea profile page

    About HeaFea

    Joined Jul '11; Posts: 17; Likes: 4.

    14 Comments so far...

  3. Visit  gracieD profile page
    4
    If they are vented, hopefully RT is traveling with you. I'd bring someone else, too (charge nurse, tech, another RN) for moral support and managing the bed, pumps, etc. Take a phone with you so you can call someone if you need to - and know the numbers you might need to call - there's no cheat sheets of numbers pinned to the walls of the hallway. Disconnect whatever isn't vital - tube feedings, maintenance fluid, etc. Call the department you are traveling to before you pack up and head out so you don't end up waiting because they weren't ready for you or they had a Stat order come up. Always speak up if you think your patient is too unstable to transport - the risk of travel must be worth the benefit of having the test/procedure done.

    In situations that make me nervous, I play the game "What's the worst that could happen?" and then think through what the best options would be before they happen. Say the patient codes in the elevator or hallway - how do you call a code in this situation? Where is the nearest code cart? What is going to be your first action/drug for the most common arrhythmias - the start of the code is going to be all you!! Or say the IV pole gets too far away from the patient and your central line for whatever reason isn't stitched gets pulled (true story), and your patient is on pressors!! Does the patient have other access? How fast can you get an IV in? I'm sure you (or others) can come up with some other nightmare scenarios from road trips.

    I find comfort and confidence in being prepared for the worst. My advice is to think through the 'worst' when you have a clear mind and you should feel prepared for whatever should happen!!
  4. Visit  anon456 profile page
    0
    at our hospital you have rt for vented pts, a nurse, and a pct that is trained in cpr. the pt gets a travel kit with all emergency meds, airway kit with ambu bag and et tube, and then of course the pumps. the pt is transported with a monitor for art line, sats, and all. we have vocera so any help can come very quickly.

    picu pts always have established ivs or lines
    in 2 locations
  5. Visit  klari profile page
    0
    Can someone mentor me .I want to work to a hospital and specialize in ccu or cvicu.I need tips where to apply and what are the things are needed.Im from Dagupan city.
  6. Visit  klari profile page
    0
    Gracied , so if i have to travel my patient to like cat scan, vented, a lot of drips, how much oxygen do i need to bring, and what are the precautions in order to prevent catasthropy in moving highly critical patient .
  7. Visit  klari profile page
    0
    Quote from anon456
    at our hospital you have rt for vented pts, a nurse, and a pct that is trained in cpr. the pt gets a travel kit with all emergency meds, airway kit with ambu bag and et tube, and then of course the pumps. the pt is transported with a monitor for art line, sats, and all. we have vocera so any help can come very quickly.

    picu pts always have established ivs or lines
    in 2 locations
    do you need to bring defibrillator too just in case and drugs.
  8. Visit  gracieD profile page
    0
    If your patient is ventilated hopefully RT is going with you so you don't need to worry about oxygen. And if the patient is so unstable that you think you need to bring the defibrillator, then you seriously need to consider if your patient is stable enough to be wheeling around the hospital for tests.
  9. Visit  StayLost profile page
    1
    There is no time I would ever NOT bring a defibillator with any of my patient, especially one that is vented. I think the poster "graciD" covered everything. If the pt is vented, RT has to come come along for the ride, and usually that is enough.

    There are times that the pt is so unstable that I insisted the MD comes with us, but that is VERY RARE. If I have to ask, they probably are too unstable for travel & shouldn't be going.

    And just one more thing --- if you have been working in an ICU for 1 year, you need to be more confident! Trust in yourself and your ability manage your patient! Apparently other's believe in you or they would not assign you that patient.
    Zombi RN likes this.
  10. Visit  Zombi RN profile page
    0
    Best tip: BECOME FRIENDS WITH YOUR RT and others you work with! Get people to help you and you will be okay! I think gracieD covered all the best bases.
  11. Visit  nyrn5125 profile page
    0
    good suggestion from gracie. unhook whatever isn't essential. I don't get vented pt's but do transport constantly on days wiith, cardiac gtt, alines, bipap, get RT, get an aide, always bring the defibrillator, atropine,lido,epi,flushes. Make sure all iv/triple lumen access is working before you leave the unit. if needed call PA to assist you or another RN. we get pt in elevator feet first just in case they code. always speak up. you'll get used to transporting soon enough
  12. Visit  Biffbradford profile page
    0
    If you feel that you need a defib along to make the trip in once piece, then DON'T GO! That patient is not stable. Fix the rhythm first.

    The most support I've done road trips with is an RT, another ACLS RN, nursing assistant, and (always) an emergency kit with ACLS drugs and some volume (Plasmanate).

    Oh Gawd, the broken IABP in the cramped elevator at 2am. What a night that was!

    I guess my hospital also had a freight elevator that was real roomy that we could have used, but I don't think we could get to the CT scanner from there.
  13. Visit  nyrn5125 profile page
    1
    [quote=Biffbradford;5672479]If you feel that you need a defib along to make the trip in once piece, then DON'T GO! That patient is not stable. Fix the rhythm first.


    The purpose is to be proactive instead of reactive. Bringing the defib/codemaster along is not because you are transporting an unstable pt. It is to be ready because you are transporting a potentially unstable at any moment pt. VT/VF can happen at any time. Regardless of fixing the rhythm they have the potential, so better to have it there for peace of mind. That is our policy at my hospital
    StayLost likes this.
  14. Visit  StayLost profile page
    1
    Quote from Biffbradford
    If you feel that you need a defib along to make the trip in once piece, then DON'T GO! That patient is not stable. Fix the rhythm first.... [and while traveling always bring] an emergency kit with ACLS drugs and some volume (Plasmanate)
    Frankly, I find it hard to believe that any prudent nurse who is caring for a patient with heart failure, so profound that they require an IABP, would feel that it's safe for this patient to leave the unit without a defibrilator. In fact, if I travel with a patient on a IABP, not only are they monitored, but I at times I will have them connected & transduced to a tram.

    With this being said, what do you plan to do with your those ACLS medications if your patient is not connected to a monitor/defibrillator?

    Just like nyrn5125 said, it's a standard and part of my hospital's policy that every patient must be connected to a monitor/biphasic defibrilator and a travel med box must be taken whenever traveling outside of the ICU. Cardiac arrythmias can happen anywhere at any time, especially when dealing with CCU patients!
    nyrn5125 likes this.


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