Inter-facility transfer of chest tubes

Question#: 638

Question:

Can ACP's still transport pt's with chest tubes if only a Heimlich valve is attached with out the use of a Pleural-Evac? It was authorized in the past and posted at OGH and Civic on BHP scope of practice documents. They have since been replaced by PPAO poster. It had also been discussed in the past by Dr Dionne in educational sessions. I cannot find current documents on the subject.

Answer:

ACPs can transport patients with chest tubes that have a Heimlich or other similar type of valve attached. However, it would be necessary to have a nurse escort if the patient was requiring the use of the pleural-evac or other similar evacuation device.

Transfer of these patients should only be done if the sending facility/doctor/ACP Paramedic has deemed this patient stable. If the patient is deemed not to be stable enough then a physician or nurse escort may be warranted. The main complication would be a tension pneumothorax, which ACP can treat, but very unlikely if the patient was stable prior to leaving the sending facility.

And lastly, it is always important to have a quick look at the chest tube and ensure that it is not clamped prior to departure.