Patient trolley

A trolley will be required to accommodate the patient for transfer both within and between hospitals. It must be safe and comfortable for the patient, and allow adequate access to accompanying staff for monitoring and resuscitation. Inevitably many pieces of equipment, such as monitors, a ventilator, pumps, and an oxygen cylinder, will have to be carried safely. An ordinary ambulance trolley is not designed for this purpose, and therefore most equipment will rest on the patient, be carried by accompanying staff, or be placed on the floor of the ambulance. This distracts the transfer team from monitoring the patient, increases the risks of accidental disconnections or extubations, may damage the equipment, and obscures observation of the monitors.

For these reasons, various modifications have been developed to improve standard trolleys with variable success. Removable shelves have been designed to be placed over the trolley above the patient. These allow good visibility and access to the equipment, but access to the patient is reduced and they can be cumbersome. Mounting brackets and poles allow the attachment of a limited amount of equipment. A shelf below the trolley provides a larger area to store equipment securely and does not impede access to the patient or equipment, but equipment may be difficult to see. Some modified trolleys require specialized mountings to secure them to the vehicle, thus precluding their more general use. Each hospital must develop a trolley system which permits efficient carriage of their chosen equipment, has the confidence of staff, and will securely fit in the vehicles usually employed for transfers.

The weight of a fully laden trolley, particularly with an obese patient, can be considerable and makes loading into an ambulance difficult. Ramps and hydraulic lifts ease this problem and reduce the risk of back injury to the transfer team.

Moving a patient from a land to an air ambulance is usually difficult. A semi-rigid vacuum mattress may assist by acting as a protective cocoon around the patient and allow easier handling. Some air ambulances use a sled system to move the patient into the aircraft and onto its special mountings.

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