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ACCTS

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Critically unwell adult patients should receive the same high standard of intensive care regardless of their location – from point of onset of illness or injury through to discharge from the Intensive Care Unit (ICU), including intra- and inter-hospital transfer.

The Welsh Government Task and Finish Group on Critical Care set out the case for improvement to specific aspects of critical care services in Wales, including establishment of an inter-hospital transfer service for critically ill adult patients.

Mission Statement

To enable uninterrupted provision of
high-quality, patient-centred
critical care for
adult
patients requiring inter-hospital transfer

 

Service Aims

  • Deliver equity of access to all critically unwell adult patients requiring transfer 
  • Streamline and expedite access to specialist care pathways, specialist decision-making and advice 
  • Facilitate patient flow in all directions, including repatriation of critical care patients within and between Critical Care Networks 
  • Maintain the highest standards of critical care throughout the patient journey from initial referral to handover in the receiving hospital  
  • Facilitate transfer outside of a network for specialist treatment or capacity should these not be available within usual referral pathways.  
  • Deliver equity of access to all critically unwell adult patients requiring transfer 
  • Streamline and expedite access to specialist care pathways 
  • Facilitate patient flow in all directions  
  • Maintain the highest standards of critical care throughout the patient journey  
  • Facilitate transfer outside of a network for specialist treatment or capacity should these not be available within usual referral pathways.  
 
Clinical Scope

1. Escalation

Patients requiring specialist care not available in the referring hospital

(A number of these patients are classified as time critical transfers)

2. Repatriation

To maintain adult critical care flow and return patients closer to their home and family

3. Capacity

Transfer from areas of high to low operational activity to ensure equity of access to high quality critical care, as seen during periods of surge and super-surge.

 

Clinical interventions
  • Advanced airway management
  • Acheostomy care
  • Non Invasive ventilation
  • Nasal High flow
  • Mechanical ventilation (inc APRV)
  • Haemodynamic monitoring
  • Vasopressors
  • Inotropes
  • Pacing
  • Mechanical CPR
  • Advanced analgesia
  • TPN
  • Blood products
  • POC arterial blood gas analysis
  • Point of care Ultrasound
  • Bronchoscopy
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