2003 OPEN FORUM Abstracts
DEVELOPING AN INTERDISCIPLINARY PROTOCOL FOR THE TRANSPORT OF PATIENTS ON NITRIC OXIDE THERAPY VIA HELICOPTER.
Suzanne Durning BS, RRT-NPS; Susan I. Maeder BSN, RN, CCRN, PHRN; Victoria D. Barkwell BSN, RN, PHRN, CMTE; Linda A. Napoli MBA, RRT-NPS, RPFT; Robyn Funk BS/BSN, RN, PHRN, CMTE; Michael Duff AS, RRT-NPS; Jason Butchko BSN/RN, PHRN, CEN; The Children's Hospital of Philadelphia, Philadelphia, PA; Andrea Snyder RN, CCRN, PHRN; Kevin L. Savidge NREMT-P, FP-C. University MedEvac Hahnemann University Hospital, Philadelphia, PA
Transporting a patient on Nitric Oxide (N.O.) therapy via rotor-wing (helicopter) can be challenging and requires a knowledgeable, specially trained, team. At The Children's Hospital of Philadelphia, the Transport Team primarily consists of Registered Nurses and Physicians. In certain circumstances, such as transporting a patient on nitric oxide, a Respiratory Therapist will accompany the team. Transporting a patient on N.O. via helicopter has its own inherent set of difficulties, due to the strict limitations of helicopter transport. A prominent issue our team encounters is weight limitations. Our institution has an agreement with University MedEvac, who primarily flies with a Sikorsky helicopter, allowing total team member weights up to 350 pounds. The isolette, including sled, currently used to transport neonates via helicopter weighs approximately 200 pounds. This weight restriction may vary depending on back-up vehicles and weather conditions. In addition to the restrictions of the helicopter transport itself, there are a number of other issues regarding transporting a patient on N.O. via helicopter. Some of these issues include:
· Covering the assignment of the therapist who will accompany the transport
· Gathering and placing the N.O. system in line with the transport ventilator
· annual helicopter safety training
In an effort to ensure that patients requiring nitric oxide therapy are transported to our institution in a safe, timely, efficient, and effective manner, we instituted a protocol for the external transport of patients on nitric oxide therapy. This protocol was developed by an interdisciplinary team, including Transport Team nursing, MedEvac University Flight Team and members of the Respiratory Care Department. Education is an integral part of this venture and to accomplish this step, we set up interdisciplinary training for helicopter safety and protocol. We prepared a poster presentation outlining specific steps for setting up and securing the nitric oxide transport system for both neonatal and pediatric patients. These posters included photographs as well as narrative to describe the nitric oxide set-up.
The protocol mandates:
· a system for N.O. transport is available at all times including
· the AeroNOx transport system (Pulmonox Corp., Tofield, Alberta, Canada
· Nitric Oxide "D" cylinder
· LTV 1000 ventilator for any intubated patient over the recommended weight range of the transport isolette
· specific seat assignments in the helicopter for each member of the team to allow appropriate personnel easy access to their respective equipment
Our institution is currently evaluating the newer isolettes/sleds made of light-weight composite materials in an effort to off-set the weight limitations for rotor-wing transport.
Helicopter transport of a patient on nitric oxide therapy can be challenging. This endeavor can be accomplished, however with a core interdisciplinary team who are committed to this goal.