Patient Transport
Principles for transporting all COVID+/PUI Patients:
COVID+/PUI patients require Airborne + Droplet + Contact precautions during transport
High-vigilance is needed to avoid and contain aerosol-generation
High-vigilance needed to minimize environmental contamination
Do not transport patients unless absolutely necessary
Designate a “clean” person to interact with environment, opening doors, clearing hallways, hailing elevators
1) Patients Requiring Oxygen
Problem Statements:
Oxygen is often required in COVID+/PUI patients
COVID+/PUI patients on oxygen may require intra-hospital transport
High-flow oxygen delivery systems risk aerosol-generation of SARS-CoV2
Transporting COVID+/PUI patients on oxygen risks disease spread to providers and environmental contamination
2) Patients Requiring NIPPV
Problem Statements:
NIPPV requires a face mask that is rarely tight-fitting
The risk of aerosol-generation of SARS-CoV2 with NIPPV is suspected
COVID+/PUI patients on NIPPV may require intra-hospital transport
Transporting COVID+/PUI patients on NIPPV risks disease spread to providers and environmental contamination
NIPPV is DISCOURAGED in all COVID+/PUI patients unless alternate support systems are deemed less appropriate
NIPPV use can be considered in Low-Risk PUI patients
3) Patients requiring Intubation and Mechanical Ventilation
Problem Statements:
Transporting intubated patients requires a coordinated team effort with several stakeholders including nursing, transporters, respiratory therapists, and physicians
Accidental circuit disconnects and accidental extubation are real risks during transport events
Transporting COVID+/PUI intubated patients on MV risks disease spread to providers and environmental contamination
High-vigilance needed to avoid and contain aerosol-generation
Transporting intubated patients includes SARS-CoV2 contaminated equipment that must be managed safely
If aerosol containing SARS-CoV2 is generated (circuit disconnect, intubation, extubation, suctioning, other) entry into the exposed room and door openings must be limited for a prescribed amount of time according to industry standard guidelines allowing for removal of air contaminants
Principles of Transport for Intubated Patients:
Use bedside ventilator to minimize circuit disconnects
Ensure adequate sedation (+/-paralysis as needed) to prevent accidental extubation
Do not move patient to a new bed unless absolutely necessary
Designate a “clean” person to interact with environment, opening doors, clearing hallways, hailing elevators
Solutions for Transport of Intubated and Mechanically Ventilated:
Updated 12/16/2020
Contact: Dr. Ana Crawford & Jacqueline Hayes Albarran, RRT