Patient packaging SOP

Question 1

Outline the contents of the patient packaging SOP

Answer 1

General principles of patient packaging
Packaging of patients with blunt trauma both supine and prone/lateral
Packaging of patient with penetrating trauma
Packaging of medical patients
Packaging of paediatric patients
Loading for air transfer

Question 2

What are the general principles of patient packaging?

Answer 2

Fundamental part of treatment
Reducing discomfort
Reducing exposure to the elements
Reduced pain, minimised blood loss, reduce heat loss
Safer moving and handling

Question 3

What risks, that we attempt to mitigate with packaging, does a severely injured patient experience?

Answer 3

Hypothermia
Further blood loss
Coagulopathy
Pain
Spinal cord damage

Question 4

Describe the order of patient packaging for trauma patients

Answer 4

Clothing off
Skin to scoop/binder - 10 degrees roll
KTD
Fleece blanket
Warmer
Blanket
Spider
Splint distal bony injuries
Into blizzard on trolley
Monitoring over right shoulder
Access to IVA
Ear protection
Onto TPLS

Question 5

What angle should head injured patients be positioned?

Answer 5

20 degrees

Question 6

What modifications do you make to the trauma packaging routine for medical patients?

Answer 6

Scoop out
Addition of automated CPR if post-ROSC
Consider permissive hypothermia if post-arrest or isolated head

Question 7

Why are children at high risk of hypothermia?

Answer 7

Higher surface area to body mass ratio

Question 8

What alternative methods or equipment can be used for the packaging of paediatric patients?

Answer 8

Vacuum splint

Question 9

What medication is almost essential pre-flight?

Answer 9

Antiemetic

Question 10

Describe the packaging process for patient with penetrating trauma

Answer 10

All the same risks
Full exposure first
Self-position onto trolley if possible
Walk the patient out if possible
Sit in a position of comfort unless clinical concern for spinal injury
Seat belts

Question 11

What are the elements of loading for air transfer?

Answer 11

• All external haemorrhage controlled
• Access to lines
• Monitoring visible
• Hearing protection
• 4-point harness
• If on a vent - load on scoop, ensure o2 switched to aircraft supply
• If awake - can self-load if appropriate, explain comms and headset, antiemetics, sedation available