DEFINITION AND CLASSIFICATION

DEFINITION AND CLASSIFICATION

DEFINITION.

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

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

for other wellbeing reasons, in vehicles exceptionally

impact.

Arrangement AND TYPES OF SANITARY TRANSPORT

We arranged TS as per diverse criteria:

Medical Non Emergency Transportation

an) According to the reason for the vehicle:

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

where the crisis jumps out at the clinic. This sort of transport is the

principal goal of this subject.

- Secondary or interhospital transport: The one did from a clinic to

other.

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

(b) Depending on the methods for transport utilized:

- Ground transportation: Ambulances.

- Air transport: Helicopters or restorative air ship.

- Maritime: Speedboats, healing center pontoon.

In light of 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 fitting.

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

adjusted.

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

c) According to the key circumstance of the patient:

- Emergency transport: must be done instantly. Has need

outright

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

with conceivable key 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 human services. Utilized

to transport patients on a stretcher.

- Ambulances: arranged for human services on the way:

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

imperative fundamental.

o Medicated. With discretionary staff. Give imperative help

progressed.

- Sanitary helicopter.

- Sanitary air ship.

PHYSIOPATHOLOGY OF SANITARY TRANSPORT.

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

modified (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 restorative exercises that will be done

the explanation behind the exchange, the challenges of the exchange, the estimated time

landing and place of goal.

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

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

of outer components about himself, about the staff that he watches over and even

on the material utilized. These components prompt physiological changes that

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

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

vibrations, temperature, turbulence and stature.

GRAVITY. Speeding up DECELERATION.

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

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

living being. Increasing speeds decelerations cause relocation of fluids and

masses inside the life form. These developments are caught by recipients

inciting reactions that can go from changes in weight

intracranial weight, diminish in pulse and increment in heart rate, up to

discomfort and vagal pictures.

In the earthly TS, longitudinal increasing speed is the most critical; 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 speeds and decelerations by

normal and judicious driving.

- The position of the patient will differ as per the sort of TS:

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

the bearing of travel.

the flying TS. In transverse or the other way

of the March.

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

indeed, even the vacuum sleeping pad 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 force level will differ. So

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

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

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

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

up to 110 decibels.

From the above we can finish up:

o Use the sirens of the ambulances, just on the off chance that it is fundamental,

o Noise may keep certain exercises, for example, auscultation

of the patient, the taking of circulatory strain, the knowing about sound alerts, and so on.

o Taking into account that clamor 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 in addition causing tension and

vegetative; acoustic assurance measures ought to be taken for the

persistent, particularly in ethereal TS.

VIBRATIONS.

Vibrations can be decreased in the accompanying ways:

or, on the other hand TS vehicles in culminate mechanical condition.

o Suspension satisfactory and in idealize condition.

Utilization of gliding stretchers.

o Immobilization of the patient with a vacuum sleeping cushion.

TEMPERATURE.

Hypothermia and hyperthermia cause physiological changes in the body.

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

air, can cause from chills to vascular crumple. The

hyperthermia causes fringe vasodilation and metabolic modifications due to

of sweating. This can be stayed away from:

o Air molding framework in the vehicle.

o Use of warm covers.

o Avoid, beyond what many would consider possible, the introduction of TS vehicles to cool 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 breakdowns.

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 decline of the climatic weight

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

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

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

tetany and obviousness. Consequently, patients with respiratory or heart deficiency,

hypovolemia, weakness, stun, and so on., can be destabilized. As a central measure

we will change the Fi O2 by checking the incomplete weight of O2 by beat oximetry.

Weight changes going with elevation changes may influence

patients and a substantial number of restorative gadgets.

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VALUATION AND STABILIZATION PRIOR TO TRANSFER

General RATING

Obviously, the basic patient might be for an assortment of reasons, let us consider

a polytrauma, an AMI, intense mid-region and a long etcetera, so that in a

the first occasion when we will be occupied with knowing the general state of the patient, the

furthermore, bolster needs and checking needs that we

need to play out the exchange. For this we will require a fast assessment

of the crucial capacities, for which we will take after the accompanying strides:

A. Aviation route with or without cervical spine control, as proper.

B. Control of ventilation and breath

C. Control of hemorrhages and circulatory help.

D. Neurological examination

E. Presentation of the patient with anticipation of hypothermia if essential.

Demand the need to take after the means successively without avoiding any of

they, until the point when we finish up the instantly past one.

Nitty gritty ASSESSMENT

This stage will intend to efficiently and

patient to have the capacity to identify any additional issue, either present or

which may entangle the underlying adjustment of the patient.

We will endeavor to know, beyond what many would consider possible, the patient's therapeutic history,

attempting to assemble all conceivable data from relatives and/or companions exhibit, also

for example, late medicines and analysis.

At this stage we will record in our medicinal records every one of those information, values

expository and parameters got amid our intercession with the patient.

We will audit all help measures started with the patient, control

circulatory, respiratory control, catheters, pathways, kind of liquids, medicine, and so forth.

The evaluation will be finished with the neurological status examination and the

regardless of whether you require sedation.

Readiness

Ampleness of the patient before beginning the exchange, comprehended as a right

treatment of the patient into the inside of the emergency vehicle, putting it in the

most appropriate position and looking for most extreme immobilization taking awesome care,

every one of those ways, tests and other material that the patient conveys, staying away from that

can endure any extubation and/or coincidental evacuation of any of the adornments,

notwithstanding putting and interfacing all apparatuses to their energy sources and

understanding exchange from our care unit to the middle area

counting an itemized and finish medicinal history

urgencies, and in addition the patient's close to home history, episodes amid the exchange

also, drug and other instrumental help gave amid the exchange