When considering an ICU transport, bring what you would need to be a mobile anesthesia unit.

Setup

Monitors

  • Some anesthesia machines have a portable monitor that you can detach and bring with you. When you get to the ICU room, hook up all lines to the patient as if you were in the OR. When you return to the OR, you just have to clip it back in and all of your data will go automatically into your anesthesia machine.
  • If your machine doesn't have a portable monitor, ask your anesthesia techs for a separate portable monitor.

Airway

  • Ambubag
  • Mapleson D/Jackson Reese
  • Emergency intubation/re-intubation supplies
    • Oral airway, blade, ETT tube
  • Consider the patient's current ventilator needs, if need be, you may need to call respiratory therapy to bring the ventilator with you

IV

  • Make sure your patient has sufficient access in case you need to push drugs along the transport. Most ICU patients already have lots of lines, but it never hurts to check just in case.

Drugs

Consider if you were to get stuck in a broken elevator with your ICU patient and you need to keep them safe. What would you need? Even if your patient is already on drips that fulfill these functions, a bolus is much faster if you need to intervene urgently/emergently.

  • Sedation - e.g. midazolam, propofol, antipsychotics if applicable
  • Paralysis if intubated - e.g. rocuronium
  • Vasoactives - e.g. phenylephrine, ephedrine, labetalol

Transport

A safe ICU transport has at least three people:

  1. Someone to manage the airway exclusively
  2. Someone at the foot of the bed to help steer and maneuver obstacles
  3. Someone at the head of the bed that would also manage lines and the IV pole - grab the lines, the pole, and one of the bed handles with one hand to absolutely prevent any lines from being accidentally pulled out

References