Transport categories

Intramural transit occurs between departments (e.g. emergency department, ICU, radiology department) in a single institution. Extramural transport involves primary (prehospital) or secondary (interhospital) missions.

Primary mission teams may be called to scenes such as explosions and major road accidents, where they may be working with prehospital support personnel (ambulance officers, paramedics, police). Entrapped patients may require on-site blood and other infusion, anesthesia (local and general), intubation, controlled ventilation, pleural drainage, or limb amputation. The environment may limit access to patients and minimum intervention compatible with safe extrication should be performed, particularly if transit time is under 20 min.

Secondary missions involve interhospital movement, usually to a major medical center for more advanced diagnostic or therapeutic measures. Examples include the following.

1. Intensive care transport from rural communities for conditions such as severe asthma, poisoning, major trauma, septic shock, and multiple organ failure. Neonates require specialized pediatric transport teams.

2. Mobile surgical or obstetric teams capable of performing procedures such as evacuation of extradural hematoma or Cesarean section for obstetric bleeding are useful for patients in remote areas.

3. Long distance repatriation of the critically ill may include medical evacuation of injured tourists and military casualties.

Coping with Asthma

Coping with Asthma

If you suffer with asthma, you will no doubt be familiar with the uncomfortable sensations as your bronchial tubes begin to narrow and your muscles around them start to tighten. A sticky mucus known as phlegm begins to produce and increase within your bronchial tubes and you begin to wheeze, cough and struggle to breathe.

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