Page 253 - 2023 SMOG Digital

3) In such circumstances, contact and consultation with medical control or other
available physician is suggested, in order to facilitate field determination of death
and cessation of resuscitative efforts.
PROCEDURE:
a. Role 2/3 provider responsibilities:
It is the responsibility of the transferring physician to write enroute care orders
appropriate for the transport environment and individualized for each patient in consultation
with the Critical Care Flight Paramedic and/or the ECCN (or attending Flight Provider) prior
to launch. The Flight Paramedic / Provider should be given a Standard Order Set for
Critical Care Transfers or similar document with en route care orders signed by the
transferring physician.
1) Provide a complete report to Flight Paramedic/Provider.
2) Provide all patient-specific related medical records.
3) Assist Flight Paramedic/Provider with packaging patient for transport as requested.
4) Complete specified areas on the appropriate patient care report
i. Administrative data
ii. Most current laboratory data
iii. Mechanism of Injury (MOI)
iv. Diagnosis
v. Procedures
5) Place patient on ventilator at least 30 minutes prior to flight. Obtain pre-flight ABG
to ensure patient tolerates ventilator settings.
6) 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 hand-off" if practicable.

b. FLIGHT PARAMEDIC / PROVIDER responsibilities prior to transfer:
1) Obtain orders for en route care from transferring physician; review orders and
discuss potential en route problems with transferring physician, reconcile
medications (ensure needed medications, specific to patient’s condition, are
obtained and prepared), allergies and patient’s weight, confirm patient’s
identification, and secure personal effects.
2) Perform primary & secondary assessment ensuring an understanding of the
patient’s injuries/illness/procedures performed.
3) Spinal immobilization is indicated during transfer if ordered by transferring
physician.
4) Assess placement and secure all tubes, lines, and drains & ensure proper
functioning.
5) Ensure endotracheal tube is secure; secure pulse oximeter/EtCO2 monitor.

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