Air transport of the patient requiring intra-aortic balloon pumping.

Air transport of the IABC patient requires a high level of skill and competence. The nurse caring for the IABP patient must be experienced in balloon pumping in a variety of settings (catheterization laboratory, operating room) and during unstable hemodynamic conditions, such as occur with arrhythmias, pacemakers, severe cardiogenic shock, and cardiac arrest. The nurse must be trained in all aspects of console operation and troubleshooting. Evanston Hospital, Evanston, Illinois, examined its experiences in ground transportation of 50 IABP patients over a 5-year period. The hospital has put forth several important principles that we have incorporated into our recommendations for air transport of the IABC patient: 1. Transport personnel should be completely familiar with the function of the IABP console; capable of handling bleeding at the balloon site, should it occur; capable of delivering intravenous medications, CPR, and ACLS; and proficient in operation of the ventilator, hemodynamic monitoring, and aerohemodynamics. 2. All patients must be stabilized before transfer. Appropriate management of hemodynamic instability and/or respiratory distress should be undertaken prior to beginning transport. 3. Medical personnel delivering care must transfer patients into and out of transport vehicles with minimal interruption of IABP. 4. Health-care professionals present during transport should be thoroughly familiar with the patient's medical status and anticipated complications. This article was not intended to teach basic principles of intra-aortic balloon pumping; rather its purpose was to discuss those characteristics of balloon pumping that are unique to flight transport and how they impact on balloon pumping. Console operation should follow manufacturer's recommendations. Table 3 summarizes features of the Aries, Datascope, Kontron, and Mansfield transport balloon pumps. Manufacturers and aircraft suppliers should be consulted for specific balloon-pump operating instructions, prior to assuming responsibility for care of the air-transport IABC patient. Well-established care plans and protocols for IABP have been published previously. Documentation of balloon-pump function during air transport is important, and can be an addenum to a standard ICU flowsheet (Fig. 4). The patient who presents at a community hospital with accelerating angina, complications following cardiac catheterization or myocardial infarction, emergency cardiac structural defects, or as a potential cardiac transplantation candidate may require institution of IABC as a life-saving intervention. Once the patient is stabilized, transport to a tertiary-care hospital that can provide advanced cardiac therapies is a logical trajectory.(ABSTRACT TRUNCATED AT 400 WORDS)