Long distance comfort during transport

[KnightRider]

I realize that manufacturers like Stryker and Ferno do not make stretchers for long-distance comfort. How do you keep your patients comfortable during a long-distance transport?

We had a 400 lb bariatric female the other day for a 2+ hour drive to a nursing/rehab facility. I was in what we call a "Vanbulance" (Type-II vehicle on a Ford E-Series van chassis), one of 2 we have (the rest are Type III). Absolutely no room to move her or make her comfortable so we tried to help as much as possible (using linens for padding, adjusting head rest, etc). At least she was a good sport about it.

 

[hometownmedic5]

Versed and Fentanyl in appropriate doses is my preferred method.

If that isnt an option, then you're SOL. To the best of my knowledge, there has never been an ambulance cot that could really in any way be considered comfortable and theres damn little you can do to change that. If theres a specific problem, like a bad hip, sure you can do some creative padding and relieve some pressure; but comfort isnt going to happen until tempurpedic starts making cot mattresses.

When I worked BLS and was taking patients on long rides, I pretty much told them it was going to suck. Once in the truck, I turned the lights off, the heat up and hoped they fell asleep. There really isnt much more you can do.

 

[Kevinf]

Throw a pillow under their butt before you transfer them to the stretcher. Our Strykers also have the option for a knee-elevated recumbent position that is generally much more comfortable with the added bonus of preventing the patient from sliding down in the stretcher.

 

[johnrsemt]

Try putting pillows under the pad;
Stop once in awhile and have your driver help to move the patient to a more comfortable position.
2 hours is nothing, try 12 to 24 hour transports.

Ask the patient what they want to do: show them what is available BEFORE they get on the cot, show them how far they can sit up, that the feet go up, and knees if that is available on your cot

 

[KnightRider]

Were not allowed to stop once in transit with a patient aboard and we dont always have the luxury of a medic to push drugs. In this case, we were a BLS truck (2 EMT-B's aboard). 12-24 hours? What the...? How does that work??

 

[DesertMedic66]

Were not allowed to stop once in transit with a patient aboard and we dont always have the luxury of a medic to push drugs. In this case, we were a BLS truck (2 EMT-B's aboard). 12-24 hours? What the...? How does that work??

You are always able to stop.

 

[VFlutter]

Thick blanket over the side rails and pillows. Position for comfort and try to change position every 30-45 mins.

 

[johnrsemt]

Stop for fuel, get drinks, etc. when you stop; stock up on snacks and drinks before you pickup patient. And they can't stop you from stopping, unless they want you to run out of fuel and then push the truck.
Usually 12+ hour transports were with 3 people, sometimes 4.
ALS or BLS depended on pt condition. If they need ALS, they got ALS, otherwise it was BLS. Although our company sent ALS a lot of times cause you never know when pt condition changes on you.
What is really fun is when you drive up on a MVC or get waved down on your way back (or on way to the pickup as case may be). Can't get on radio and call for help, and calling 911 on cell doesn't always work, unless you pay good attention to the Mile Marker posts as you drive, cause you don't know where you are. Which is even worse when you transport from a MVC and you have to ask patient where the closest hospital is.

 

[GMCmedic]

"I'm sorry sir/ma'am, I need my partners help to make you more comfortable but company policy dictates we cannot stop. Would like the number to my supervisor to express your concern about that?"


When patients complain, things get done.

 

[ThadeusJ]

We had the egg crate foam for the larger patients on longer flights. Part of the issue wasn't just the padding but the narrowness of the stretcher, limiting the positioning.

 

[SpecialK]

This is why I liked having entonox; it was good for long transports as there was hundreds of litres in the cylinder. MOF doesn't last as long.

 

[EpiEMS]

This is why I liked having entonox; it was good for long transports as there was hundreds of litres in the cylinder. MOF doesn't last as long.

I wish we had that...I've yet to see it on a BLS (or ILS, for that matter) protocol in the U.S., even though it is taught to AEMTs in initial training.