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1. Intrahospital transport of the
critically Ill patient

2. Objectives
● Describe major risk factors and common problems
associated with transport of critically ill patients.
● Explain the safe organized transport of critically ill
patients using the “5 W’s”.
● List the most important equipment required for safe
transport.
● Describe proper monitoring of patients for safe transport.

3. Introduction
 Preventing common complications and maintaining
physiologic stability is a challenge even in the controlled
environment of the ICU.
 Safe transport requires thoughtful planning, organization,
and interdisciplinary communication and cooperation.
 The goal during transport is to maintain the same level of
care, regardless of the location in the hospital.

4. Assessment of Risk for Complications
 Complications may arise from physiologic changes,
environmental conditions outside the ICU that are difficult
to control or inadvertent movement of equipment.
• 76% risk of complications in critically ill patients
• 84% of heart patients develop arrhythmias
• 46% of problems related to equipment
• 25.8% of problems related to lines.
(Source: Critical Care Nurse, 2010, Health Science Journal
volume (8) 2014)

5. Major Risk Factors
 High ventilator support
 Many tubes and lines
 Hemodynamic instability

6. Common Problems
1. Related to equipment:
• Monitor power failure
• Ventilator disconnection
• Depleted oxygen supply
• Tubes getting kinked
2. Related to patient condition:
• Aspiration
• Arrhythmias
• Hypothermia
• Pain

7. Common Problems
3. Related to staff:
• Gaps in monitoring
• Over-ventilation
• Under-ventilation
• Inadequate knowledge in interpretation and operation of
equipment
The most common problems were cardiac
arrhythmias and equipment problems.

8. Safe Organized Transport
Remember the 5 W’s
Why: Necessary, evaluating risk/ benefits, alternative
Who: Patient, staff
What: Equipment, ongoing interventions, facilities in the
destination
When: Time of procedure
Where: Best route, special safety requirement

9. Recommended Equipment
Airway:
• oral/nasal airways
• soft wrist restraints and sedation
• Intubation tray
Breathing
• Pulse oximeter
• Oxygen delivery devices and bag-mask ventilator
with positive end expiratory pressure (PEEP) valve
• Full oxygen tank with adequate length tubing

10. Recommended Equipment
Circulation :
• Cardiac monitor with defibrillator
The most important equipment is:
A- Airways
B - Breathing: oxygen and saturation monitor
C- Cardiac monitor with defibrillator

11. Monitoring During Transport
 Continuously monitored
 Oxygen saturation
 ECG monitoring
 Intermittent monitored
 Blood pressure
 Breath sounds

12. Key Points
 Major risk factors during intra-hospital transport are
high ventilator support, numerous tubes/lines and
hemodynamic instability.
 The most common problems encountered during
intra-hospital transport are arrhythmias and equipment
problems.
 Five W’s: When, Why, What ,Who, and Where.

13. Continued
 Remember important equipment to take during
transport: A- airways, B- oxygen and saturation
monitors, C- cardiac monitor
 Continuous oxygen saturation and ECG/cardiac
monitoring is mandatory for all ICU patient
transports.

14. Questions
 The most common problems encountered during
intra-hospital transport of critically ill patients are
______ and _______ .
 The three major risk factors are____ , ____ and ____.
 The 5W’s stand for:
 What are the most important equipment required for
safe intra-hospital transport?
 ______ and ______ are mandatory to monitor during
intra-hospital transport.