Peter‐Marc Fortune

Manchester University NHS Foundation Trust

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Cassie Lawn

University Hospitals Sussex NHS Foundation Trust

Bernard Foëx

Manchester Royal Infirmary

Steve Byrne

Orange Regional Medical Center

Sue Wieteska

David Inwald

Cambridge University Hospitals NHS Foundation Trust

Mark Peters

University College London

Robert C. Tasker

Boston Children's Hospital

Roger Parslow

University of Leeds

Claire Snowdon

London School of Hygiene & Tropical Medicine

Margrid Schindler

Bristol Royal Hospital for Children

Cooperative Institutions

National and Kapodistrian University of Athens

201

Imperial College London

176

Panagiotis & Aglaia Kyriakou Children's Hospital

164

Patan Academy of Health Sciences

160

Sotiria General Hospital

155

Nationwide Children's Hospital

The Ohio State University

University College London

Children's Hospital of Philadelphia

Medical University of Graz

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CHiP: summary of protocol amendments

Duncan Macrae Richard Grieve Elizabeth Allen Zia Sadique Helen Betts

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Safety and the team

Bernard Foëx Peter‐Marc Fortune Cassie Lawn

Safely transporting a critically ill patient requires a coordinated approach. The transport environment is hazardous. Travelling in the rear compartment of a road ambulance or aircraft is fraught with potential danger. Health and safety at work regulations have several specific provisions which are pertinent to the field of transfer medicine. This chapter focuses on safety in the transport environment in terms of: the team, the patient, the carers, the vehicle and equipment, and the organisation. If carers accompany the transport team it is important that they have appropriate clothing and footwear for all eventualities as described above for the staff. When travelling in the ambulance, family must always wear the seatbelt provided. It must be made clear that they must not release it unless the ambulance has come to a halt and the transport team and/or driver instruct them that it is safe to do so.

10.1002/9781119144953.ch12

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Preparation and packaging

Bernard Foëx Peter‐Marc Fortune Cassie Lawn

This chapter describes how to prepare the patient, equipment and personnel for transfer and explains the importance of a structured approach to the preparation and packaging of a patient for transfer. The acronym MINT (Medical, Instrumentation, Nursing, and Transportation) may be used to remind the team that 'preparation and packaging' does not only involve the physical preparation and continued treatment of the patient. Transportation is a reminder of whether the patient is to travel by cot, bed, incubator, hospital trolley or ambulance trolley. Before the transfer, the team leader must ensure that the patient is physiologically optimised and that all team members are fully briefed about the patient's needs. The key goal in packaging the patient is to achieve both physical security and accessibility. Physical and visible access to airway, breathing and circulation devices and equipment should be considered during packaging.

10.1002/9781119144953.ch9

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The Structured Approach to Transfers

Steve Byrne Steve Fisher Peter‐Marc Fortune Cassie Lawn Sue Wieteska

This chapter contains sections titled: Introduction Assessment Control Communication Evaluation Preparation and Packaging Transportation Summary

10.1002/9781444300833.ch2

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Clinical considerations for adults

Bernard Foëx Peter‐Marc Fortune Cassie Lawn

This chapter describes how the systematic ACCEPT approach enables movements of ill and injured patients between or within hospitals. Centralisation of specialist services means more transfers for clinical reasons. Many of these transfers will be time critical, some will be intensive, and some will be both. The chapter provides an overview of the patient groups that typically will need to be transferred to specialist centres, some of their characteristics and associated specific clinical management. Some of these broad categories of patients includes: neurosurgery (traumatic brain injury, cerebral bleeds), trauma, burns, vascular surgery (abdominal aortic aneurysm, thoracic aortic dissection, acute limb ischaemia), interventional radiology, cardiology (primary coronary intervention), nephrology (acute renal failure), obstetric, and level 3 transfers. However, early and effective communication between centres is essential to ensure that any specific treatments are administered before or during the transfer to optimise patient care.

Centralisation

Nephrology

10.1002/9781119144953.ch15

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Should children ever be living kidney donors?

Pediatric Transplantation (2006)

Nicholas J.A. Webb Peter‐Marc Fortune

Abstract: Living kidney donation by minors is an infrequently performed although highly controversial procedure. This manuscript reports the frequency of this practice in North America, Europe, Australia and New Zealand. The relevant laws and professional guidelines are reviewed and the ethical considerations discussed.

Kidney donation

10.1111/j.1399-3046.2006.00522.x

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Questionnaire on use of health services

Duncan Macrae Richard Grieve Elizabeth Allen Zia Sadique Helen Betts

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The motor response to stimulation predicts outcome as well as the full Glasgow Coma Scale in children with severe head injury*

Pediatric Critical Care Medicine (2009)

Peter‐Marc Fortune Frank Shann

To evaluate how well the full Glasgow Coma Scale and the motor response, which is a subscore of the Glasgow Coma Scale, predict the outcome in children who have sustained a traumatic brain injury. The best scores in the first 24 hrs were used.A retrospective observational study.A pediatric intensive care unit.Children admitted between January 1997 and December 1999.None.Recovery with independent function (good outcome), or death, persistent coma, or dependent (bad outcome) at 6 months after the injury. Complete information was available for 130 patients. Both the full Glasgow Coma Scale and the motor response predicted outcome well: the area under the receiver operating characteristic plot was 0.88 (95% confidence interval, 0.82-0.95) for the full score and 0.89 (0.82-0.95) for the motor response.Both the full Glasgow Coma Scale score and the motor response provide a useful indication of long-term outcome, although neither score is sufficiently accurate to be used to limit treatment. The full Glasgow Coma Scale does not have a linear relationship with mortality, and there is poor interobserver agreement. The motor response should be used in children in preference to the full Glasgow Coma Scale; the predictive power is equivalent to the full Glasgow Coma Scale, there is a linear relationship to mortality, and it is easier to collect accurately.

Coma (optics)

Glasgow Outcome Scale

10.1097/pcc.0b013e3181c014ab

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The Infectious or Contaminated Child

Steve Byrne Steve Fisher Peter‐Marc Fortune Cassie Lawn Sue Wieteska

This chapter contains sections titled: Introduction The Potentially Infectious Child A - Assessment The Potentially Contaminated Child Summary

10.1002/9781444300833.ch18

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Neonatal, adult and paediatric safe transfer and retrieval : a practical approach to transfers

Wiley-Blackwell eBooks (2019)

Bernard Foëx Peter‐Marc Fortune Cassie Lawn

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