Safe Retrieval and Transfer: the Practical Approach

Abstract

There is a considerable number of published papers that demonstrate the risks associated with the interhospital transfer of sick patients. Unfortunately, with a national shortage of intensive care beds, the number of interhospital transfers shows no sign of reducing. This book provides a framework for safe transfer of sick patients and is written by a multi-professional group representing the Advanced Life Support Group. It is also the course manual for the Safe Transfer and Retrieval (StaR) course run by the same organization. The subject of effective patient transfer is not littered with entertaining anecdotes, and most readers are likely to want to be taken through the subject quickly and painlessly. The book is well laid-out with short chapters, many of which can be read in only a few minutes. Many readers might find the style too didactic but, if seen as one safe method of achieving the desired objectives, this ceases to be a problem. The subject is covered comprehensively. Areas that are vital (and often neglected), such as effective patient packaging and stabilization, are given good coverage. Other areas are of relevance, but are unlikely to be utilized regularly by most transfer doctors e.g. radio voice procedure. Three-and-a-half sides are devoted to diagrams and text on the fixation of tracheal tubes'obviously one of the authors has bad memories of a tube displacement on a rainy motorway somewhere. Most of the content is predictable and well thought out'unlike some multi-author texts, the editors have ensured consistency. Well-established ‘ABC’ type treatments form the mainstay of the guidelines. However, some areas touched upon are controversial, and it would be useful if they were highlighted as such for the less experienced reader. For example, it is suggested that not all critically ill patients necessarily need a doctor to transfer them from one hospital to another. It may be that the specific circumstances where this is appropriate are explained in the StaR course, but reading the book alone could cause problems. Also, the suggestion that the administration of steroids in spinal injury is mandatory will be questioned by some UK neurosurgical units. Overall, this book achieves its aims well, and adhering to the clear and well-presented guidelines will undoubtedly reduce the number of preventable adverse events during patient transfers by anyone that follows them.