B.11. How would you organize and conduct the transport of this patient to the operating room?
Answer:
Proper transport of this patient to the operating room requires attention to patient monitoring and safety, essential medications, equipment, and team coordination. Patient monitoring should consist of a continuous ECG trace for arrhythmia and HR monitoring, invasive arterial catheter for continuous blood pressure monitoring, and audible pulse oximetry. The transport monitor should be confirmed to be functional, positioned so that the vital signs are clearly displayed, and the battery fully charged. An adequate oxygen supply and an effective oxygen delivery device should be initiated before transport. Emergency airway equipment and a defibrillator should accompany the patient. Intravenous access should be functional and secured with clearly identified injection ports for medication administration. Vasoactive infusions initiated by the treatment team should be verified and infusion pump settings confirmed. Syringes of vasopressors and inotropes, including phenylephrine, epinephrine, norepinephrine, calcium, and in-line intravenous fluid for volume resuscitation should be available for transport.
Given her respiratory distress, this patient should be transported in her position of comfort, likely sitting up. Transport to the operating room should not begin until there is sufficient transport personnel present to monitor and treat the patient, and safely operate the bed; the operating room should be ready to receive the patient with the staff and perfusionists prepared, the surgeon immediately available, and blood products in the room.
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