MedBugs: SAQ #367

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Case: Paediatric extradural haematoma transfer

A 6-year-old boy presents after being struck on the side of the head by a baseball. He has an isolated head injury, GCS 14/15 and has vomited three times. CT brain demonstrates an extradural haematoma. He has been accepted for transfer to a tertiary paediatric centre for neurosurgical intervention.

1. State three specific problems with road transfer as a mode of transport. 3 marks

2. State three specific problems with helicopter as a mode of transport. 3 marks

3. State three specific problems with fixed wing as a mode of transport. 3 marks

4. List four monitoring requirements that should be available as a minimum standard for all transfers. 4 marks

There is ongoing discussion between yourself, the neurosurgeon and the retrieval consultant as to whether this child should be intubated prior to transfer.

5. State three advantages to endotracheal intubation prior to transfer. 3 marks

6. State three disadvantages to endotracheal intubation prior to transfer. 3 marks

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