Approach to stabilisation and transfer

Checklist prior to transporting a child

After successful resuscitation of the seriously ill or injured child, frequent clinical reassessment must be carried out to detect deterioration or improvement with therapy. All patients should have the following monitored:

• Oxygen saturation
• CO₂ monitoring
• Arterial pH and gases
• Pulse rate and rhythm
• Blood pressure
• Urine output
• Core temperature
• Skin temperature

Checklist prior to transporting a child

• Is the airway protected and is ventilation satisfactory? (substantiated by blood gases, pH, Sats and capnography if possible)
• Is the neck properly immobilised?
• Is there sufficient oxygen available for the journey?
• Is vascular access secure and will the pumps in use during transport work by battery?
• Have adequate fluids been given prior to transport?
• Is the child receiving adequate sedation, analgesia and, if used, paralysis
• Are fractured limbs appropriately splinted and immobilised?
• Are appropriate monitors in use?
• Will the child/baby be sufficiently warm during the journey?
• Is documentation available? Include:
  • Child’s name
  • Age & date of birth
  • Known or estimated weight
  • Clinical notes
  • Observation charts, including neurological
  • The time and route of all drugs given
  • Fluid charts
  • Ventilator records
  • Results of investigations, including blood, urine, x-rays and scans
  • Names and contacts of medical and nursing staff involved in referral, receipt and during transport
• Is the necessary resuscitation equipment available?
• Is appropriate treatment available for managing emergencies, e.g rising intracranial pressure?
• Has the case been discussed with the receiving team directly?
• Has the receiving unit been advised of an estimated time of arrival?
• Have plans been discussed with the parents, including issues of consent?