Patient safety-escorted transport?

EmergencyNrse · Sep 23, 2011

Anything that needs/meets Critical Care Transport criteria...

Sedated, intubated, micro drips...

STEMI, CVA, Precipitous Delivery...

You call, I come.

silentRN · Sep 23, 2011

In the ICU we transfer ICU status patients to all procedures with an RN. Once the patient becomes floor status we just use transport unless they need to be on tele

nerdtonurse?, BSN, RN · Sep 23, 2011

When I take a patient to CT in the middle of the night, and they're relatively stable, I take them on a remote monitor. If I have any idea whatsoever that they could go sideways, I pull meds from the Pyxis that I think I might need (telling my charge so that I don't go home with something in a pocket), like Ativan, Haldol, Zofran, etc., that were ordered as PRNs. I also took a patient (with a doc's order) with IV Cardizem in my pocket in case they went back into SVT during a bleeding scan. That was soooo not a fun night.

Altra, BSN, RN · Sep 23, 2011

OK, here goes:

ICU patients (and that includes ER patients who are being admitted to an ICU) don't go anywhere without a nurse, nurse aide, and RRT if intubated. A pack of code drugs goes with them.

Tele patients who must remain monitored during transport can be transported by a monitor tech, nurse or ER paramedic ... unless they have a gtt running (NTG, Heparin, Cardizem, etc.) In that instance they require a nurse.

You specifically asked about ER seizure patients ... some ER seizure patients get discharged, some will get admitted to Tele, and some to a med-surg floor. Ativan or Valium don't routinely go with them during transport ... only if their seizure risk was considered significantly high enough to require a nurse carrying meds, ready to intervene if necessary. We have no formal policy such as time since last seizure, etc.

Med-surg patients and those patients whose physicians agree are stable enough to be non-monitored long enough to go for a test are transported by Patient Transport staff who do just that -- move patients in wheelchairs and on stretchers from place to place -- they have no training to otherwise intervene.

Other than ICU patients, code drugs or other meds do not routinely go with the patient. It's up to the individual nurse's discretion.

Special procedures (I'm assuming you mean GI Lab, Fluoro, interventional radiology?) all have nurses in those areas -- only rarely is it required that the patient's assigned nurse remain with them.

MAISY, RN-ER, BSN, RN · Sep 23, 2011

Anything that needs/meets Critical Care Transport criteria...
Sedated, intubated, micro drips...
STEMI, CVA, Precipitous Delivery...
You call, I come.

Thanks for the reply, but the ambulance is a little wider than what my hallways can handle....should have noted intrahospital! :clown: :LOL

Esme12, ASN, BSN, RN · Sep 23, 2011

Hi everyone,
Looking for any patient transport policies your facility may be using for critical patients.....
do you transfer seizures with a nurse? with ativan? monitored? If so, standing orders? time table (last seizure)
do you transfer patients on drips monitored? with an RN/
do you transfer your cva patients with airway box? med kit(intubation possibility)? monitored? with an rn?
How about special procedures? Do you stay with any of the above?
What is your criteria?
Any info would be appreciated-facility policies would be great too!
Thanks,
Mary

Let's see......For a community hospital of about 300 beds......

1) If the patient is on any monitored drips that require a monitored bed, they must be accompanied by a RN and monitor (unless other wise indicated by the MD)

2) Any ICU patient is accompanied by a RN (UOWIBMD) and monitor.

3) NO patient is transported with Chest Pain unless cleared by MD (for admission or Special Procedures).

4) All epidural infusions are accompanied by Licensed personnel when patient leaving department.

5) All monitored patients will be transported with med box, ambu bag and O2 tank (intubation kit kept in ED for

codes in tackle box to be brought when code is called)

6) All intubated patient accompanied with RN, O2, monitor, and RRT for management of airway.

7) Patient on telemetry, pain free, negative enzymes my be transported by transport if cleared by MD without

monitor. ie: soft rule out to telemetry.

Special procedure nurses handle the patient at the facility and the SP nurse or I would monitor patient for transport back to the department or ED. I hope this helps

http://innovations.ahrq.gov/content.aspx?id=2313

http://www.incontrol.biz/incontrol/documents/icu_patient_transport_decision_card.pdf

http://archive.ahrq.gov/clinic/ptsafety/pdf/chap47.pdf

http://www.patientsafetyauthority.org/ADVISORIES/AdvisoryLibrary/2009/mar6(1)/Pages/16.aspx

Roy Fokker, BSN, RN · Oct 3, 2011

Great replies y'all.

Heck, if I think the situation warranted it, I've even had the MD come with me to CT (mostly semi-unstable-but-not-totally-unstable (KWIM?) traumas/bleeds).

But generally: All "Unit" patients are transported with monitor and RN (with drugs and with RRT if intubated). All "telemetry" patients are transported with RN and monitor (with drugs in pocket PRN).

By and large though: if I think my patient might be unstable or I'm not happy with presenting symptoms or progression of case or if my gut doesn't feel right - I go with the patient. Better safe than sorry.

cheers,