SYMBOLHow can a critical care or emergency department nurse prepare a patient for the flight team?
Remember the ABCs of aeromedical transport:
Airway. Establishing a definitive airway is imperative. Be prepared to assist the physician or flight team in endotracheal intubation. If the patient is already intubated, insert a nasogastric tube to facilitate gastric emptying and enhance ventilation.
Breathing. If the patient is on a ventilator prior to the flight, relay the vent settings to members of the flight team, enabling them to calibrate and set up their ventilator before arrival at your facility. During your phone report, provide them with local weather conditions and the patient's weight (both are of primary concern to the pilot).
Circulation. Insert at least two large-bore IV lines and initiate appropriate fluid management. An intraosseus line is acceptable in pediatric patients. Attach a urimeter to the urinary catheter, which will enable the flight team to measure urinary output and, subsequently, renal perfusion.
Disability. Assess the patient's baseline neurologic status. Most transport teams require that you immobilize the trauma patient on a long board to provide spinal stabilization.
Examination. Prepare a detailed but concise report of your head-to-toe examination; include diagnostic test results, radiology reports, and information about medications administered or treatments rendered. Paperwork and transfer forms should be ready upon the team's arrival.