Managing Ventilation During Transport

Abstract

Previous chapters have considered the provision of artificial ventilation in an emergency to overcome life–threatening hypoxia. Transport ventilation is different from emergency ventilation and concerns the safe movement of a patient who is dependent on a ventilator, but in a stable condition from one location to another. This may range from short distances with the hospital, for example from the ICU to imaging units or over many thousands of miles during a medical evacuation from one continent to another. There are inherent risks associated with transport ventilation associated with both the environment and the movement of the patient and special vigilance is required.

Transport ventilation over long distances is usually controlled by medical specialists using relatively sophisticated ventilators. However it, is important that non-specialists providing basic transport ventilation should have a basic understanding of the capabilities of pneumatic and electronically–controlled transport ventilators.

Guidelines for the safe conduct of transport ventilation have been issued and these should be supplemented by special training for those involved. Equipment checking and the organisation of oxygen supply to be adequate for the planned journey is essential. Careful monitoring of the patient is essential during transport, no matter what is the distance involved. This should be based upon clinical skills of observation and auscultation, supplemented by the information given from ventilator monitoring systems and alarms. In common with emergency ventilation, a supplementary means of ventilation should be available at all times and used when any unexplained problem arises.