> It is my fear (possibly ungrounded) that discontinuing a drip for
> transfer might result in a 2-3 hour interruption of an infusion. It is
> this interruption I see as 'mediocre'.
>
However, only a minority of admissions benefit from ongoing IVs in any case.
Not many orthopaedic emergencies require infusions. Most cases of
respiratory disease, stroke, acute coronary syndrome, heart failure etc.
won't benefit from an infusion. Many of these will be unsuitable for
transfer with either tech or para crews due to a question of actual or
potential physiological instability. However, most stable strokes, moderate
pneumonias, asthma and COPD if fit for transfer will have no detriment from
not having an infusion for a few hours. And of course the big cause of
medical admissions at present is the elderly patient with multiple
pathologies, none of them all that bad, but unfit to go home (off the legs/
pubic ramus fracture etc.). I would imagine a reasonable number of patients
could be identified where not running an IV for a few hours (or indeed at
any time during their admission) will be of no detriment. Might even get
people thinking a bit (away from the idea that every admission need a
venflon and every venflon needs maintenance fluids).
As a general rule, I would say that if a patient being considered for
transfer is having an ongoing infusion it is to their benefit to reassess
whether they benefit from it. And if they do benefit from it, the
appropriateness of transfer at that point could be profitable readdressed.
> I envisage that the cannula gets capped as soon as transport is booked
> (maybe this does not happen)
> I envisage a 'non-urgent' transfer waiting around 90 minutes. (Maybe
> this does not happen)
> I envisage it taking up to an hour for a new ward arrival to start
> treatment, like a drip, simply because there will be other things
> happening on a ward.
That's policy and can be addressed if it's a problem. Make it the job of the
nurse handing over the to ambulance to cap the drip and the job of the nurse
at the other end to restart it if this is an issue.
Matt Dunn
Warwick
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