Reference — Transport Respiratory Care
Transport Monitoring Parameters
The minimum monitoring standard for a transported critically ill patient plus the stability targets to optimize before you leave — and the ETCO₂-to-PaCO₂ gradient that shapes how you read capnography in motion.
Written by Apex Respiratory Editorial Team
Educational use only. This material supports respiratory therapy education and exam review. It is not medical advice and is not a substitute for clinical judgment, institutional protocols, or physician orders. Always follow facility policies and current provider orders, and verify calculations independently before clinical use.
Overview
A transported patient should be monitored at the same level as in the ICU. This reference lists the minimum continuous monitoring for the critically ill patient and the stability targets to optimize before departure.
Minimum Monitoring Requirements
| Parameter | Requirement | Note |
|---|---|---|
| ECG | Continuous | Detect rhythm changes; visual display essential in loud cabins. |
| Pulse oximetry (SpO₂) | Continuous | Degraded by motion artifact and poor perfusion; corroborate. |
| Blood pressure | Continuous or at least every 5 min | Arterial line preferred for unstable patients. |
| Capnography (ETCO₂) | Continuous for intubated patients | Confirms ventilation and tube placement; best in-motion monitor. |
| Temperature | Continuous for neonates | Cold stress is a respiratory issue in the newborn. |
Optimize Before Departure
| Target | Aim |
|---|---|
| Airway | Secured and position-confirmed by capnography. |
| Oxygenation | SpO₂ at the ordered target on a transportable FiO₂; supply calculated for the trip + reserve. |
| Ventilation | Settings verified; exhaled Vт and PEEP confirmed on the transport ventilator. |
| Hemodynamics | Stable on infusions running on charged pumps; access secured. |
Clinical Notes
- ETCO₂–PaCO₂ gradient. ETCO₂ normally reads a few mmHg below PaCO₂; the gradient widens with increased dead space or low cardiac output, so treat ETCO₂ as a trend and ventilation confirmation, not an exact PaCO₂.
- Alarm configuration. Set both audible and visual alarms and position monitors within view.
- Tube position verification. Reassess and re-confirm tube position after every patient move or transfer.
Related Resources
Sources
- Warren J, Fromm RE Jr, Orr RA, Rotello LC, Horst HM; American College of Critical Care Medicine. Guidelines for the inter- and intrahospital transport of critically ill patients. Crit Care Med. 2004;32(1):256-262.
- Kacmarek RM, Stoller JK, Heuer AJ. Egan's Fundamentals of Respiratory Care. 12th ed. Elsevier; 2021. Monitoring in respiratory care.