Anesthesia/Sedation Preoperative Care and Preparation Clinical Pathway, Inpatient and Emergency Department

Determining Personnel Required for Transport to Procedure Area

If there is a question about patient's clinical stability, defer to the more trained clinician to transport.
Guidelines for Transporting Patients Within the Hospital Job Aid

Anesthesia Respiratory Therapist, RN as Needed, review checklist APU Guidelines Job Aid	Cardiovascular Hemodynamic instability Vasoactive continuous infusions Exception: low dose dopamine for renal perfusion
	Respiratory Receiving heliox or nitric oxide delivered non-invasively Indications for portable ventilator use during transport PEEP ≥ 10 cmH₂O or FiO₂ ≥ 40% Alternative modes of ventilation, e.g., APRV, HFOV, VDR Continuous non-invasive ventilation Inhaled nitric oxide Elevated ICP Note: RT not needed for transport for chronically trached, mechanically ventilated patients on stable settings
	Neurologic Alteration of mental status ICP monitoring Concern for elevated ICP with symptoms, EVD included Deep sedation infusion
	Devices Present Umbilical venous catheter (UVC) Umbilical arterial catheter (UAC) Intraosseous (IO) access
Registered Nurse	Requiring ICU-level care Tracheostomy present 2 of the following: RN RT Trained caregivers Infusing IV Transport outside main hospital Buerger MRI Perelman Center for radiation therapy
Support Staff/Ancillary	Vital sign frequency not required < q4hr Saline locked IV Foley catheters and surgical drains Capped peritoneal dialysis catheters Includes: senior nursing aide, clinical support associate, certified medical assistants, paramedic, ED tech, nurse tech
Transport Tech OR Tech	Stable, saline locked IVs, no other devices

RN/RT Checklist for Anesthesia Pick-Up

Communication	Call procedure area for timing. Leave contact information Parent/guardian at bedside, or contact number
Documentation	ID, allergy band in place Paper chart, if applicable
Medications	Pre-op antibiotics as required Emergency medications, if applicable Necessary medication, infusions, fluids and pumps, including necessary medications due to be given during procedure
Equipment, Emergency Supplies	Artificial airway Portable suction, with in-line suction catheter, yankauer, emergency tracheostomy go bag Full oxygen tank Clamp EVD just before patient transport, if applicable Fully charged CR monitor with CVP, A-line, ETCO₂ as necessary
Additional Personnel	Bedside RN travels with Anesthesia as needed RT assistance by guidelines above

If you have questions about any of the clinical pathways or about the process of creating a clinical pathway, please contact us.

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The clinical pathways are based upon publicly available medical evidence and/or a consensus of medical practitioners at The Children’s Hospital of Philadelphia (“CHOP”) and are current at the time of publication. These clinical pathways are intended to be a guide for practitioners and may need to be adapted for each specific patient based on the practitioner’s professional judgment, consideration of any unique circumstances, the needs of each patient and their family, and/or the availability of various resources at the health care institution where the patient is located.

Accordingly, these clinical pathways are not intended to constitute medical advice or treatment, or to create a doctor-patient relationship between/among The Children’s Hospital of Philadelphia (“CHOP”), its physicians and the individual patients in question. CHOP does not represent or warrant that the clinical pathways are in every respect accurate or complete, or that one or more of them apply to a particular patient or medical condition. CHOP is not responsible for any errors or omissions in the clinical pathways, or for any outcomes a patient might experience where a clinician consulted one or more such pathways in connection with providing care for that patient.

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Anesthesia/Sedation Preoperative Care and Preparation Clinical Pathway, Inpatient and Emergency Department

Determining Personnel Required for Transport to Procedure Area

RN/RT Checklist for Anesthesia Pick-Up

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Anesthesia/Sedation Preoperative Care and Preparation Clinical Pathway, Inpatient and Emergency Department – Anesthesia Transport

Anesthesia/Sedation Preoperative Care and Preparation Clinical Pathway, Inpatient and Emergency Department

Determining Personnel Required for Transport to Procedure Area

RN/RT Checklist for Anesthesia Pick-Up