- Management of the ventilation of a patient during a prolonged or interfacility transport of an intubated patient.
- Transporting personnel should review the operation of the ventilator with the treating personnel (physician, nurse, or respiratory therapy) in the referring facility prior to transport if possible.
- All ventilator settings, including respiratory rate, FiO2, mode of ventilation, and tidal volumes should be recorded prior to initiating transport. Additionally, the recent trends in oxygen saturation experienced by the patient should be noted.
- Prior to transport, specific orders regarding any anticipated changes to ventilator settings as well as causes for significant alarm should be reviewed with the referring medical personnel as well as medical control.
- Once in the transporting unit, confirm adequate oxygen delivery to the ventilator.
- Frequently assess breath sounds to assess for possible tube dislodgment during transfer.
- Frequently assess the patient’s respiratory status, noting any decreases in oxygen saturation or changes in tidal volumes, peak pressures, etc.
- Note any changes in ventilator settings or patient condition in the PCR.
- Consider placing an NG or OG tube to clear stomach contents.
- It is strongly recommended that the airway (if equipment is available) be monitored continuously through Capnography and Pulse Oximetry.
- If any significant change in patient condition, including vital signs or oxygen saturation or there is a concern regarding ventilator performance/alarms, remove the ventilator from the endotracheal tube and use a bag-valve mask with 100% O2. Contact medical control immediately.