Patient Transfer Protocol
Safe Transfer of Critically Ill Patients - Complete Guidelines
Central Principle
A safe transfer is not the fastest transfer. A safe transfer is one where the patient arrives alive, documented, expected, and no worse than when they left.
Pre-Transfer Stabilization - ABCDE Assessment
A - AIRWAY
RED FLAG
Do NOT transfer a patient with falling GCS, severe agitation, aspiration risk, or worsening respiratory failure without deciding whether airway control is needed before leaving.
B - BREATHING
For Ventilated Patients - Document:
- Mode: _________ FiO₂: ____% PEEP: _____ cmH₂O
- Tidal Volume: ______ mL, RR: ______ /min
- SpO₂ before leaving: ____%, EtCO₂: ______ mmHg
C - CIRCULATION
D - DISABILITY (Neurological)
Head Injury/Stroke Priorities:
- Prevent hypoxia, hypotension, hypercapnia
- Maintain cervical spine precautions if trauma
- Secure ETT well, maintain sedation
E - EXPOSURE & TEMPERATURE
Final Pre-Transfer Verification
Critical: Oxygen Calculation
Formula: Available oxygen (L) = Cylinder capacity (L) × Pressure (bar)
Duration (min) = Available oxygen ÷ Oxygen flow rate
SAFETY RULE
Take at least DOUBLE the calculated oxygen requirement to allow for delays, breakdowns, waiting for bed space, or unexpected deterioration.
Example Calculation:
- 10L cylinder at 200 bar: 10 × 200 = 2,000L available
- Patient needs 15 L/min: 2,000 ÷ 15 = 133 minutes calculated
- Safe working duration: ~60-65 minutes (assuming half)
Key Principle:
"A safe transfer is not the fastest transfer. A safe transfer is the one where the patient arrives alive, documented, expected, and no worse than when they left."