The equipment used for in-hospital transfers has been combined to form complete transfer systems. These are generally not commercially available as hospitals have developed their own systems to suit their particular needs. Descriptions have been published and the systems appear to fall into three general types.
1. The same mobile ICU is used for in-hospital as well as interhospital transfers. This system has been used successfully by the Clinical Shock Study Group in
Glasgow for many years but it involves an extra transfer of the patient and therefore may be inherently more dangerous ( Runcie et §L 1.991). Other mobile ICU
suitable for interhospital transfers have also been described.
2. Carts and trolleys which clip or attach to the bed can be developed but may become redundant if the ICU obtains new incompatible beds.
3. The additional equipment may be attached to or carried on the bed. This option may be the most cost effective as specialist engineering work is minimized and purpose-made tables offered by the bed manufacturers can be used.
The most important considerations are ease of transfer, patient comfort, portability, set-up time, and ease of cleaning. Drugs, fluid, and nutrition
The pharmacological support offered to the patient should continue during transfer. Continuous inotropic or vasodilator therapy may be mandatory and so must be continued irrespective of the complexity that this adds to the transfer. Emergency drugs (T§ble...3) and a checklist must be carried in case of an acute cardiorespiratory decompensation.
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