TRANSPORTATION OF INFANTS AND CHILDREN And Nursing Responsibilities

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When an infant or child must be transferred from one unit to another within the same hospital or from one hospital to another, the nurse has specific responsibilities she must carry out before releasing the child for transfer. It is a nursing responsibility to assess the needs of the child and determine that the equipment and environment during transportation are safe and adequate to meet the child’s individual needs.

Principles

Nursing Responsibilities

1. Identification is necessary to assure the return of a patient to his proper location within the hospital and to establish his / her identity unequivocally.

The nurse must ensure the appropriate identification is affixed to an infant before she leaves the crib. The infant’s identification should be rechecked before replaced in the crib.

2. When infants are moved, each infant should be transported separately to prevent cross-infection A special stretcher or bassinet should be reserved to transport infants outside the pediatric unit. Each time it is used the crib or stretcher should be draped with clean linen to prevent cross contamination

3. Provisions for the safety of the child during transportation are essential.

A responsible staff member should accompany the infant at all times.

Adequate restraints (a stretcher strap or crib net) must be used.

4. A doctor’s approval is required to transport an infant from the unit when to do so requires interruption of a therapeutic measure. (eg. Oxygen)

A record should be entered on the chart indicating where the child was taken, why, and for how long.

The infants therapeutic needs should be considered before removing him from his crib.

5. The temperature of the corridors will be lower than the temperature in the pediatric unit.

The child should be adequately clothed and covered to prevent chilling during transportation.

6. The technique of carrying an infant is based on his anatomic structure and motor ability. The principles of safety must be observed.

Head and back support is necessary to young infants.

Since an infant’s movements are unpredictable the nurse must hold the child securely to protect him from injuries.

 

Carrying the Infant

The Cradle Position

When an infant is carried in the cradle position, head and back are supported adequately by the nurse’s arm. Note that she grasps his thigh with her hand to ensure a secure hold. Her other arm is free for activity.

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The Upright Position

The infant’s head must be supported until he is able to do so by himself. The upright position is not recommended when the nurse desires to have one arm free for activity. If only one hand is used, this hold will not allow for the infant’s unexpected movement, and there is danger of resultant back strain. The infant’s head should not come in contact with the nurse’s face.

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The Football Position

In the football position the head is supported with the hand, the back is supported by the forearm, and security is maintained by gently pressing the infant’s buttocks between the nurse’s elbow and her hip. This position is useful when the nurse wishes to have one hand free for other activity.

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Nursing Responsibilities

1. Positioning and restraining the child to prevent falls is essential. A restraining strap should be used when transporting children on stretchers or in wheelchairs.

2. The body temperature should be maintained by means of blankets or equipment such as portable incubators.

3. Adequate means of identification of the patient must be attached.

4. A copy of the patient’s records or chart should accompany him to maintain communication between the sending and receiving units.

5. During ambulance transfer, a light should be available to facilitate observation.

6. Equipment to maintain warmth and prevent hypothermia and a clean area should be provided to minimize exposure to contaminants.

 

TRANSPORTATION OF INFANTS AND CHILDREN

Transporting Children in Shock:

1. Equipment necessary to measure and record blood pressure must be available.

2. If intravenous replacement fluids are running, equipment for administering the fluid under pressure may be required because elevation of IV bottles to a desirable level may be limited in an ambulance.

Transporting Children with Head Injuries:

1. A nasogastric tube to prevent vomiting and aspiration should be placed.

2. The head should be slightly elevated to minimize increased intracranial venous pressure.

3. Body alignment should be maintained when positioning and moving the child.

Children in Respiratory Distress

1. An unobstructed airway must be maintained.

2. The child’s stomach should be empty, or a nasogastric tube should be inserted prior to transportation.

3. Do not feed a child immediately prior to a planned ambulance transfer.

4. Suction equipment should be on hand in case vomiting occurs.

5. The child should be positioned and restrained so that he can be turned if vomiting occurs.

6. Airways, an Ambu bag or portable resuscitator, and full oxygen tanks should accompany the child in respiratory distress.

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