Re: High risk OB transports

[jim.kendrick@att.net]

Hi David,

I am currently a flight nurse with ER trauma 
background.  However, at the beginning of my nursing 
career I worked in a high risk L&D for 10 years. (Yikes! 
I guess I am dating myself, huh?) I was responsible for 
the clinical education for all the staff.  I am also 
currently responsible for all the OB education for my 
flight program. I wrote our OB Launch criteria.  In 
addition I made "cheat OB cards" for all our crew.  
These are quick OB refernce cards that supply all the 
pertinent OB pearls that you need for transport.  I also 
have supplied our crew with quick reference cards 
regarding the most common OB/Fetal pathologies.  
Included is info about the pathology, maternal and fetal 
affects, pertinent meds, treatments, pertinent labs, 
etc.  Our flight program does not take OB team members.  
After the OB training was complete our crew felt 
competitent in transporting high risk OB patients and 
interpeting FHR tracings.

We do document FHT's in flight but only with a doppler.  
Most fetal monitors are too big and/or expensive for 
most programs to carry.  If you are looking for a great 
fetal monitor I would recommend the Hewlitt Packard 
Fetal monitor.  I have never used one in flight so I do 
not know how much vibration from the aircraft could 
cause artifact on the monitor.  Our program documents 
FHT every 5 minutes during flight.  UC's are assessed by 
palpation every time we check FHT's.


I am happy to share any information that you would need 
but OB is a pretty broad subject.  Is there anything 
specific I could help you with?  If you are interested I 
could possibly be available to train your crew in OB 
transport issues including FHR interpetation.  In most 
cases training could occur with in 2-3 days.
Sincerely,
Teri Campbell RN
Memorial Air Angels
> Need the groups expertise in getting some feedback regarding high risk 
> transports.  Either reply to me directly or to the list.  dasteele1@qwest.net
> 
> 
> 1.  Are there any programs out there with specific guidelines when to transport 
> High risk OB patients or better yet when not to transport those patients i.e. 
> dilated to 10cm and pushing...
> 
> 2.  If so are you willing to share those?  Or at least give me the nuts and 
> bolts of it?
> 
> 3.  Are there any programs out there that don't do High risk OB transports
> 
> 4.  Who takes team members?,  OB nurse? Doc? Neonate team etc.  How many.
> 
> 5.  Who does in flight monitoring of Uterine contractions and fetal heart rates?  
> If so what monitor are you using?  How much orientation do you get before you 
> may interpret strips regarding contractions, decels, variability etc.
> 
> 6.  Any other information that might be useful regarding policies affecting OB 
> transports would be greatly appreciated.
> 
> Thanks in advance
> 
> David Steele RN
> Flight nurse
> 
> http://www.users.qwest.net/~dasteele1
> 
> 

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