Preflight Preparation for Air Medical Transport

AIRWAY

  • If intubation is required - age/4 + 4 = ETT size (e.g. a four year old child would require a #5 ETT)

Confirm ETT position with chest x-ray

BREATHING

  • Ventilate with oxygen as required to maintain pulse O2 saturation > 95%
  • Use airway pressure as needed to maintain air entry and chest wall expansion

CIRCULATION

  • Monitor - Heart rate and rhythm, oxygen saturation, temperature and blood pressure
  • Volume Depletion - Treat with 10 - 20 mls/kg of normal saline IV fluid
  • Secure Two Large Bore IV sites for the critically ill child. (An extension tubing between your IV cannula and infusion set will facilitate rapid change over to our team's infusions)
  • Fluid Management - Normal Saline or Ringer's Lactate; for children under 1 year of age use D5NS or D5RL

Guidelines for Determining IV Fluid Rate

<1 month of age = 5 cc/kg/hr
1month - 2 years = 4 cc/kg/hr
2 years - 10 years = 3 cc/kg/hr
10 years or age = 2 cc/kg/hr

Procedures To Consider Or Discuss With The Medical Control Physician

  • Pneumothoraces - Place chest tube prior to flight for pneumos > 25%, tension, or increasing in size
  • Blood Work - Recent blood gas, CBC, glucose and electrolytes (if possible)
  • Recent x-ray
  • NPO - Large bore orogastric or nasogastric tube
  • Foley Catheter - In all seriously ill or injured patients unless urethral injury is suspected
  • For Trauma Patient - Chest x-ray, c-spine and pelvic x-ray (if possible)

All Trauma Patients Will Remain on a Backboard for Transport Regardless of X-Ray or Physical Findings

The Transport Team Will Require The Following Prior To Leaving

  • Photocopy of patient's chart including admission history, lab reports, etc ...
  • Relevant x-ray and CT films
  • A brief transfer note from the attending MD (if possible)

A parent or family member may request to accompany the child during the transport.

Many factors influence this decision such as; weight restrictions, number of medical crew, weather conditions, and safety.

Please discuss this issue or any other concerns with the Air Medical Crew.