checklist

Critical Care Transfer, Transport & Transfusion Safety Checklist (Interactive)

An interactive, saveable checklist for interfacility and intrahospital critical-care transfers that combines pre-transfer stabilization, communication & handoff script, equipment/medication verification, and a transfusion safety sub-checklist. Designed for real-time use, documentation, and training.

Interactive Tool

Critical Care Transfer, Transport & Transfusion Safety Checklist

Use this checklist for every high-risk intrahospital or interfacility transfer. Complete required fields, mark each step, use the SBAR handoff fields to document the clinical summary, and capture signatures. If transfusion is planned or ongoing, complete the transfusion safety section. Incorporate this checklist into local transport and ICU protocols and train via simulation.

Patient name

Full legal name

MRN / Identifier

DOB (optional)

YYYY-MM-DD or as local system uses

Sending unit / location

Receiving unit / destination

Planned/actual transfer time

Local time

Sending clinician (name & role)

Receiving clinician (name & role)

Transfer priority

Transport mode

Pre-transfer stabilization - complete each before leaving (mark Yes/No)

If No is selected, document mitigation in comments.

Airway secured / appropriate airway device present

Ventilator settings documented and portable ventilator available if needed

Oxygenation acceptable / SpO2 target met with plan

Hemodynamics acceptable or supported (pressors documented)

IV/IO access patent and secured

Analgesia / sedation plan provided and medication available

Resuscitation / emergency equipment present and checked (bag, airway kit, defib)

Relevant labs and imaging available or attached to transfer documentation

Blood products present or ordered (if indicated)

Pre-transfer comments / unresolved issues

Describe any instability, anticipated problems, or contingency plan

Communication & handoff (use SBAR below)

Confirm each item before transport.

Receiving team notified and acknowledged readiness

Bed/space availability confirmed at destination

Transfer documentation (orders, summary, labs, imaging) sent with patient or available electronically

Transport escort assigned (name/role captured below)

Transport escort name & role

Driver is separate from clinical escort

SBAR — Situation: brief statement of current problem

SBAR — Background: key background/events/diagnoses

SBAR — Assessment: current status and stability

SBAR — Recommendation: what receiving team should expect/plan

Equipment & medications — confirm presence (check all that apply)

Check items that accompany the patient.

Equipment present

Portable monitor/defib

Transport ventilator + circuits

Oxygen cylinder (secured)

Infusion pumps & tubing

Suction device

Airway kit (intubation equipment)

Emergency medications (epinephrine, atropine, etc.)

Blood products (if applicable)

Key active infusions / meds to continue during transport

Include rates and syringe concentrations

Is transfusion planned or ongoing?

If Yes, complete the transfusion safety section.

Pre-transfusion verification: patient ID, blood unit & compatibility checked by two clinicians

Two-person verification at bedside is recommended

Blood product labels match patient ID & order

Transfusion monitoring plan (vitals frequency, escalation triggers)

Transfusion consent and documentation available and copied with transport record

Final time-out & checks before movement

Confirm identity, allergies, site, procedure (if applicable).

Patient identity & allergies confirmed at bedside

Team time-out completed and documented

Post-transfer / receiving confirmation

Arrival time at destination

Receiving clinician accepts patient and acknowledges key issues

Receiving clinician comments / immediate plan

Signatures / accountability

Sending clinician name & role (typed name serves as signature)

Receiving clinician name & role (typed name serves as signature)

Transport escort name & role (typed)

Training & usage note

Use simulated transfers to practice this checklist. Local teams should adapt wording, add local contacts, and map to electronic health record workflows.

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Critical Care Transfer, Transport & Transfusion Safety Checklist (Interactive)

Critical Care Transfer, Transport & Transfusion Safety Checklist

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