TRANSPORTATION OF THE PATIENT IN A CRITICAL STATE

DEFINITION AND CLASSIFICATION

DEFINITION.

We characterize TS (Sanitary Transport), as per Royal Decree 1.211/1.990 in its article

133, for example, that improved the situation the removal of wiped out individuals,

for other wellbeing reasons, in vehicles uncommonly

impact.

Medical Non Emergency Transportation

Characterization AND TYPES OF SANITARY TRANSPORT

We characterized TS as per diverse criteria:

an) According to the motivation behind the vehicle:

- Primary or extrahospital transport: The one that is completed from the place

where the crisis strikes the healing facility. This sort of transport is the

basic target of this subject.

- Secondary or interhospital transport: The one completed from a healing facility to

other.

- Tertiary or intrahospital transport: Within the healing center itself.

(b) Depending on the methods for transport utilized:

- Ground transportation: Ambulances.

- Air transport: Helicopters or medicinal air ship.

- Maritime: Speedboats, healing facility pontoon.

With regards to the separation to be voyage, either methods for

transport:

- For separations under 150 km, earthbound or

helicopters.

- Between 150 and 300 km the ideal methods for transport is the wellbeing helicopter.

- Distance in the vicinity of 300 and 1,000 km. Make the utilization of the planes prudent.

- The bosses to 1000 km advantage from the exchange by general line

adjusted.

- For certain extraordinary conditions the ship or railroad is cleared out.

c) According to the imperative circumstance of the patient:

- Emergency transport: must be completed instantly. Has need

supreme

- Urgent transport: it can take minutes or hours. These are patients

with conceivable essential hazard.

- Delayable transport: transport can be modified. Does not require

prompt help.

d) According to the level of medicalization of the vehicle framework:

- Non-restorative ambulances: no enrichment for medicinal services. Utilized

to transport patients on a stretcher.

- Ambulances: arranged for human services on the way:

________________________________________

Page 2

o Non-medicalized. Without discretionary staff. Can offer help

crucial essential.

o Medicated. With discretionary staff. Give crucial help

progressed.

- Sanitary helicopter.

- Sanitary air ship.

PHYSIOPATHOLOGY OF SANITARY TRANSPORT.

The main thought to be considered amid TS, regardless of whether essential or

customized (optional and tertiary), is the solid mental effect that it

the cognizant patient. This effect is limited by educating the patient, if conceivable,

relatives or sidekicks about the remedial exercises that will be done

the explanation behind the exchange, the troubles of the exchange, the surmised time

entry and place of goal.

Having called attention to out, we should consider that assembling a patient,

notwithstanding the methods for transport utilized, involves the activity of an arrangement

of outside components about himself, about the staff that he looks after and even

on the material utilized. These components prompt physiological changes that

can irritate the patient's condition, so it is critical to know them. The

physiological changes are created by, among others, the impact of gravity, clamor,

vibrations, temperature, turbulence and tallness.

GRAVITY. Increasing speed DECELERATION.

The speed changes amid TS, the two expands (increasing speed) and

(deceleration) of the same, cause physiological changes in the

life form. Increasing speeds decelerations cause dislodging of fluids and

masses inside the living being. These developments are caught by recipients

inciting reactions that can extend from changes in weight

intracranial weight, diminish in circulatory strain and increment in heart rate, up to

discomfort and vagal pictures.

In the earthly TS, longitudinal quickening is the most noteworthy; being of

transverse or anteroposterior increasing speeds in TS in

helicopter. For all the above we will consider the accompanying:

- Avoid, beyond what many would consider possible, sudden increasing velocities and decelerations by

consistent and reasonable driving.

- The position of the patient will fluctuate as indicated by the sort of TS:

the earthly TS. Understanding in prostrate position with head in the feeling of

the course of travel.

the ethereal TS. In transverse or the other way

of the March.

- Correct jetty of the stretcher to the vehicle and the patient on the stretcher, utilizing

indeed, even the vacuum bedding for its ideal immobilization.

- Use of safety belts by going with faculty.

- Correct settling and assurance of the material and utilization of imbuement pumps

for the organization of vasoactive medications.

Clamor.

Contingent upon the kind of TS utilized, the clamor source and its power level will fluctuate. So

in arrive transport the clamor is for the most part caused by the sirens of the

ambulances; in spite of the fact that record should likewise be taken of movement

________________________________________

Page 3

streets, put away electromedical material and the vehicle's own particular commotion. At

air transport, particularly in helicopters, the commotion level is high.

up to 110 decibels.

From the above we can close:

o Use the sirens of the ambulances, just in the event that it is fundamental,

o Noise may keep certain exercises, for example, auscultation

of the patient, the taking of pulse, the becoming aware of sound cautions, and so forth.

o Taking into account that commotion levels of 70 db. cause changes in the

rest in grown-ups and changes in heart rate and vasoconstriction

fringe neuropathy in the neonate, and also causing tension and

vegetative; acoustic security measures ought to be taken for the

tolerant, particularly in aeronautical TS.

VIBRATIONS.

Vibrations can be lessened in the accompanying ways:

or, then again TS vehicles in consummate mechanical condition.

o Suspension sufficient and in idealize condition.

Utilization of drifting stretchers.

o Immobilization of the patient with a vacuum sleeping pad.

TEMPERATURE.

Hypothermia and hyperthermia cause physiological changes in the body.

Hypothermia, to which is especially delicate the injury understanding presented to

air, can cause from chills to vascular crumple. The

hyperthermia causes fringe vasodilation and metabolic changes due to

of sweating. This can be maintained a strategic distance from:

o Air molding framework in the vehicle.

o Use of warm covers.

o Avoid, beyond what many would consider possible, the presentation of TS vehicles to icy or warmth.

TURBULENCES.

They are caused by the air going through the airborne TS vehicle. It causes jerks

which can be a wellspring of observing mistakes and glitches.

This is maintained a strategic distance from with a decent settling framework that keeps individuals and

material.

Stature.

The reduction of the incomplete weight of oxygen and abatement of the barometrical weight

decides the principal impacts that the stature causes in which it flies.

The physiological impacts of hypoxemia happen from 1000 m. Among them

features the expansion in cardiovascular yield and reflex hyperventilation, respiratory alkalosis,

tetany and obviousness. In this manner, patients with respiratory or cardiovascular deficiency,

hypovolemia, paleness, stun, and so forth., can be destabilized. As a major measure

we will change the Fi O2 by observing the halfway weight of O2 by beat oximetry.

Weight changes going with height changes may influence

patients and an extensive number of therapeutic gadgets.