Name of the Procedure:

Transfer of Care during an Anesthetic or to the Intensive Care Unit (ICU)

• Common names: Care Handoff, ICU Transfer
• Medical terms: Transfer of Care, ICU Handoff, Anesthetic Transition

Summary

Transfer of care during an anesthetic or to the ICU involves shifting a patient's care responsibility from the surgical team to the intensive care unit team or to another appropriate care team while the patient is still under anesthesia. This ensures continuity of care and addresses the patient's specific medical needs.

Purpose

• Medical Conditions: Critical illness, severe postoperative complications, complex surgeries requiring intensive monitoring
• Goals/Outcomes: Ensure safe transition of care, maintain patient stability, provide specialized post-surgical or critical care

Indications

• Symptoms/Conditions: Hemodynamic instability, respiratory distress, complex surgical recovery, need for specialized monitoring
• Patient Criteria: Patients undergoing major surgeries, those with pre-existing conditions warranting intensive care, or those developing complications during anesthesia

Preparation

• Pre-procedure Instructions: None specifically for transfer; however, patients typically follow pre-surgical instructions like fasting and medication adjustments per surgery type.
• Diagnostic Tests/Assessments: Pre-surgical assessments, continuous intra-operative monitoring

Procedure Description

1. Continuous Monitoring: Patient vital signs are continuously monitored.
2. Anesthetic Management: Patient remains under the anesthesia administered by the anesthesiologist.
3. Communication and Documentation: Detailed handoff communication between the surgical team and the ICU team, including patient status, performed procedures, and ongoing care requirements.
4. Transportation: Patient is transported using specialized equipment to maintain vital functions and stability.
5. ICU Handoff: The ICU team assumes care, with the anesthesiologist providing comprehensive details on anesthesia and patient condition.

Tools and Equipment

• Monitors for vital signs
• Anesthesia delivery systems
• Patient transport equipment (e.g., gurney, ventilator if required)

Anesthesia/Sedation

• Continuation of anesthesia administered during surgery

Duration

• Typically, 15 to 30 minutes depending on the complexity and coordination required

Setting

• Performed within a hospital setting

Personnel

• Healthcare Professionals: Anesthesiologist, surgical team, ICU team (intensivist, critical care nurses)

Risks and Complications

• Common Risks: Minor drops in blood pressure, temporary discomfort
• Rare Risks: Severe hemodynamic instability, respiratory complications, delayed recovery
• Management: Continuous monitoring, emergency interventions by the ICU medical team

Benefits

• Expected Benefits: Seamless transition of care, improved patient outcomes, specialized monitoring and treatment, reduced complications
• Realization Time: Immediate upon transfer completion

Recovery

• Post-procedure Care: Intensive monitoring, stabilization, ongoing treatment in ICU
• Recovery Time: Varies depending on patient condition and procedure complexity
• Restrictions/Follow-up: ICU-based restrictions and tailored follow-up plans

Alternatives

• Treatment Options: Direct recovery in post-anesthesia care unit (PACU), step-down units
• Pros/Cons:
  • PACU: Less intensive monitoring, suitable for less critical cases
  • Step-down Units: Intermediate care for stable yet still closely monitored patients

Patient Experience

• During Procedure: Typically unaware due to anesthesia
• After Procedure: Waking up in a controlled ICU environment, potential discomfort managed with medications
• Pain Management: Ongoing assessment and pain control measures, comfort provided by ICU staff