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6) Review ABG – ABG should be done within 30 minutes of flight; patient should be
on transport ventilator with vent settings for transport; ABG obtained 15 minutes
after being placed on transport ventilator.
7) Ensure vascular access X 2 - peripheral, central or IO and A-line as needed.
8) Check all bandages, splints, dressing, fixation devices and tourniquets for
placement and ensure no evidence of ongoing hemorrhage.
9) If indicated, insert OG/NG tube for gastric decompression, especially in intubated
patients; cap or place to suction.
10) Empty Foley catheter bag prior to flight; ensure UOP documentation by
transferring facility.
11) For an intubated patient, provide adequate analgesia and sedation PRIOR to
giving additional paralytic medications. Re-dose medications as needed prior to
flight in accordance with transferring physician’s orders.
12) Continue administration of blood products if ordered by transferring physician. If
anticipated administration of blood products enroute, Flight Paramedic/Provider
should request orders for blood products and appropriate blood products from
the transferring physician and use FDA approved fluid warming device as
appropriate for warming fluids.
13) Collect all patient care documentation for transport with patient, i.e. pre-hospital,
transport, labs, x-rays, transferring facility notes, etc.
14) Remove all air from IV fluid bags and place all free flowing bags in pressure
bags.
15) Ensure patient is properly packaged in a warming device unless contraindicated
prior to transfer. Follow directions specific to each warming device ensuring over
heating or thermal burns do not occur. Hypothermia, acidosis and coagulopathy
constitute the “triad of death” in trauma patients.
16) Securely affix all equipment, supplies, loose tubing and lines to NATO litter prior
to moving the patient to the vehicle or aircraft.
17) Once patient is packaged, ensure all lines are leveled and monitors are zeroed.
18) Provide eye and ear protection to patient.
c. Special considerations:
1) Eye Trauma: Fox shields should be placed for any patient with a suspected or
confirmed open globe, possible intraocular foreign body or eye injury. DO NOT
remove impaled or stubborn foreign bodies from the eyes. (even contact lens)
SHIELD AND SHIP. DO NOT PLACE ANY DRESSINGS UNDER RIGID EYE
SHIELD or manipulate the injured eye. Both the injured and uninjured eye should be
covered IOT avoid excessive movement of the injured eye which may result from
involuntary convergence. Also want to avoid nausea/vomiting in these patients.
Normal Saline may be used to rinse eyes in awake patient with no penetrating injury.
(JTTS CPG - Initial Care of Ocular & Adnexal Injuries)
2) Compartment Syndrome: Patients with extremity injuries, abdominal
injuries/surgery, burns, coagulopathy and those who have received massive
transfusion are at risk for compartment syndrome. Ensure proper assessment prior

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