Page 232 - 2026 SMOG

POST-OPERATIVE AND CC INTERFACILITY TRANSFER
˚ Provide a complete report to the Flight Paramedic/Provider.
˚ Provide all patient-specific related medical records.
˚ Assist Flight Paramedic/Provider with packaging the patient for transport as requested.
˚ Complete the specified areas on the appropriate patient care report
Administrative data
■
■ Most current laboratory data
■ Mechanism of Injury (MOI)
■ Diagnosis
■ Procedures
˚ Place the patient on a ventilator at least 30min prior to flight. Obtain a pre-flight ABG to
ensure the patient tolerates the ventilator settings.
˚ It is strongly suggested that the transferring physician make every possible attempt to contact
and discuss the case with the receiving physician or facility representative. Flight Paramedics
and ECCNs should confirm or encourage this vital “physician-to-physician handoff” if
practicable.
• FLIGHT PARAMEDIC/PROVIDER responsibilities prior to transfer:
˚ Obtain orders for en route care from the transferring physician; review orders and discuss
potential en route problems with the transferring physician; reconcile medications (ensure
needed medications, specific to the patient’s condition, are obtained and prepared), allergies,
and the patient’s weight; confirm the patient’s identification; and secure personal effects.
˚ Perform primary and secondary assessments, ensuring an understanding of the patient’s
injuries/illness/procedures performed.
˚ Spinal immobilization is indicated during transfer if ordered by the transferring physician.
˚ Assess placement and secure all tubes, lines, and drains & ensure proper functioning.
˚ Ensure the endotracheal tube is secure; secure the pulse oximeter/EtCO monitor.
2
˚ Review ABG—ABG should be done within 30min of flight; patient should be on transport
ventilator with vent settings for transport; ABG obtained 15min after being placed on
transport ventilator.
˚ Ensure vascular access × 2—peripheral, central, or IO—and A-line as needed.
˚ Check all bandages, splints, dressings, fixation devices, and tourniquets for placement and
ensure no evidence of ongoing hemorrhage.
˚ If indicated, insert an OG/NG tube for gastric decompression, especially in intubated
patients; cap or place to suction.
˚ Empty Foley catheter bag prior to flight; ensure UOP documentation by the transferring
facility.
˚ For an intubated patient, provide adequate analgesia and sedation PRIOR to giving
additional paralytic medications. Redose medications as needed prior to flight in accordance
with the transferring physician’s orders.
˚ Continue administration of blood products if ordered by the transferring physician. If
anticipated administration of blood products en route, Flight Paramedic/Provider should
request orders for blood products and appropriate blood products from the transferring
physician and use an FDA-approved fluid warming device as appropriate for warming fluids.
˚ Collect all patient care documentation for transport with patient, i.e., pre-hospital, transport,
labs, xrays, transferring facility notes, etc.
˚ Remove all air from IV fluid bags and place all free-flowing bags in pressure bags.
(continues)

224 • PROCEDURES