Prepare Patient for Transport

The transport medicine environment is dynamic and challenging. To carry out the transport safely, your patient may need interventions prior to transport that would not be performed if the patient remained in your hospital.
 
Physician to Physician communication may be clinically helpful and/or necessitated; there is an Ornge Adult and Paediatric Transport Medicine Physician available 24/7 by contacting our Operations Control Centre: 1.833.401.5577

To ensure the absence of restricted items on patients, the Operations Control Centre may also require sending facilities to conduct searches (where possible) before patients board. This includes checking for knives, lighters, and other items. For a detailed list of restricted items as per Transport Canada, please click here.

To minimize the time the Ornge crew needs to prepare the patient for transport, please ensure to make copies of all documentation for the crew to bring to the receiving hospital, including:

• Incident history and relevant past medical history
• Medications and allergies
• Treatment and response to treatment, equipment, ongoing infusions and therapies
• Recent vital signs and pertinent physical findings
• 12-lead ECG (when pertinent) results and significant lab values
• Diagnostic imaging results – if on PACS or CD, please allow crew to view images
• For intubated patients - please obtain a chest x-ray post intubation.
• Resuscitation status: DNR or advanced directives

You will need to have the following prepared (*as appropriate):

• Intravenous access (2 large bore peripheral IV’s if hypotensive, active/severe hemorrhage, severe trauma, sepsis or burns)
• Foley*
• Gastric tube*
• Airway supported / secured* (e.g. GCS<=8)
• Recent VBG if ventilated
• Spinal immobilization*
• Arterial line* (Note: This is strongly recommended in any patient with hemodynamic instability)
• Central line*
• Blood products*
• Pregnant patients in active labour require a recent pelvic exam within the last hour prior to transport to assess likelihood of imminent delivery
• Medications (prn or regular) administered prior to transport particularly if being transported by primary care paramedics who will not be able to administer this in flight e.g. antinauseant, analgesics as appropriate
• Extremity fractures are splinted

The Ornge transport team will do the following when they arrive at your location:

• Take history and do brief physical assessment
• Review copies of patient's chart and other pertinent data
• Contact the Transport Medicine Physician for medical direction as required
• Ensure patient is prepared for the transport:
  • Cardiac, blood pressure, oxygen saturation monitoring.
  • Ensure all IV accesses are well secured and place pressure bags on intravenous fluid bags and use infusion pumps as necessary. Lines and/or circuits may need to be switched to Ornge equipment for compatibility purposes.
  • Secure the airway for intubated patient by checking ETT placement (clinically and/or CXR) and ensure ETT taping is appropriately secured.
  • Stabilize patient on a transport ventilator for intubated/ventilated patients.
  • Administer any drugs or treatments required by TMP prior to departure.
  • Perform other interventions as required.
  • Transfer patient to a stretcher and/or other specialized transport equipment as applicable and securely strap in place.
  • Speak to family as appropriate regarding patient’s condition, plans for transport and destination.
  • Endeavour to bring a family member escort when requested and/or otherwise applicable to do so, pending available seating and asset restrictions.

Sending accurate measurements ensures that the most appropriate resource is dispatched. The underreporting of measurements may lead to delays.
 

Width (Widest Point)

Width is a one-dimensional measurement straight across the patient from their widest point (while supine). It’s as if you were holding a meter stick over the patient rather than a measuring tape. This area could include their shoulders  hips, or whatever part of their body is the widest. Please have this measurement available in cm. 
 

Girth (Lap/Seatbelt)

This is a measurement from the mattress over the patient and back to the mattress again. This is where we will place a lap seatbelt over the patient during the transport.  
 

Height

This measurement is from the bottom of the patient’s foot to the top of their head. Please have the patient’s height available in cm.
 

Upper Arm Circumference

This measurement is from around the patient’s unflexed upper arm (or bicep). Please have this measurement available in cm.
 
 
By providing accurate and precise measurements, you can do your part to help ensure safe and timely transport for patients.