Guideline for the Retrieval of Critically-ill Children from the IOW by Ferry Introduction

The retrieval service performs 10-15 retrievals per year from the . Most are done during ferry timetable hours. In the event that the transport cannot be done by ferry and it is not deemed safe to delay the transfer until the following day a helicopter transfer will be organised. (See air transport guideline) As the team must perform the retrieval around the availability of a ferry, this can add considerable time to the length of the transfer. Good initial advice, ongoing discussions, and prompt organisation and planning of retrieval times are essential. It is imperative that this is treated as a normal retrieval and safe practice is observed. This means that the child’s safety ALWAYS comes first, and no retrieval should be rushed to fit in with the ferry times.

2. Retrieval Process

2.1 Referral Call 2.1.1 It is important to remember that when taking the initial call that the point of contact with the child by the retrieval team may be delayed slightly by ferry availability. 2.1.2 Accurate information about the patient and good advice for management is essential. 2.1.3 When it is determined that retrieval is required the team must quickly determine which mode of transport is to be used, ferry or helicopter. 2.1.4 If the child has a neurosurgical emergency the referral team should bring the patient (see the management of traumatic brain injury guideline)

2.2 Accepting a referral 2.2.1 The PICU consultant must discuss the referral with the referring team and give advice on the clinical management of the child while they wait for the retrieval team. 2.2.2 The PICU consultant will decide whether the ferry or helicopter will be used. 2.2.3 If the retrieval is at night, check the ferry timetable to ensure there is a service running: www.redfunnel.co.uk/ferry-travel or Wight Link www..co.uk

2.3 Pre-departure 2.3.1 To book the Red Funnel ferry call: 08448 449988 Monday to Friday 0800 -1900hrs Weekends 0800 -1800hrs Outside of these hours please call the Terminal controller on Soton 07974310193 07976844425 2.3.2 At each booking please quote The PICU account number: FSWH05. 2.3.3 The following information is needed by the ticketing office: 1. Retrieval of patient from St Mary’s Hospital by the Paediatric Intensive Care Retrieval Team, by ambulance (may need priority loading and unloading). 2. Number of people on board the ambulance. 3. Account number (FSWH05). 4. Give the pre-assigned unique UHS/ PICU Order Number found on the Booking Form (See Appendix One). These are kept in the technician’s office. 5. Retrieval Ambulance Vehicle Registration Number (X 999 ALF), Transfer Ambulance Vehicle Registration Number (HN52 FX2). 6. Time of departure.

7. Time of return – it is imperative that this is worked out beforehand. Ensure there is adequate time between arriving and departing the island to get to the hospital (30 minutes), stabilise the child (minimum 60 minutes), and returning to the ferry (30 minutes). The ticketing office will advise the closest ferry time available. 2.3.4 You will receive a reference number that needs to be given at the ticketing office to receive the tickets. This should be recorded on the referral document. 2.3.5 If there is going to be a delay in getting the team to Town Quay please telephone Red Funnel on 07974 310193 and they may delay departure of the ferry for a few minutes. 2.3.6 If they cannot assist, we can use the Wightlink Service, based at . To book the Wightlink call: 0239 2855260 Monday to Saturday 0700-2100hrs Sunday 0800-2000hrs. For out of hours bookings please call the terminal controller on: Gunwarf 07768657931 Fishbourne 07867537214 2.3.7 Inform the technician of time of departure – do not request immediate arrival on PICU if departure is going to be delayed.

2.4 At the Ferry Terminal 2.4.1 On arrival report to the ticketing office you will need the booking form (appendix one). 2.4.2 You will need to provide the following information: 1. Reference number 2. Vehicle Registration 3. Number of people on board.

2.5 On board the Ferry 2.5.1 When there is no patient on board, the Retrieval Team must leave the vehicle and go to the passenger lounge. 2.5.2 When a patient is on board the vehicle, the team will stay with the patient. 2.5.3 A crewmember will check how many of the team are staying, and whether you need power. 2.5.4 They will provide an extension board for our use.

2.6 Prior to departing the Referring Hospital

2.6.1 The child must be adequately stabilised before departure. 2.6.2 Telephone PICU consultant to give a clinical update and discuss ongoing management. 2.6.3 Telephone PICU to give estimated time of arrival and give any information regarding equipment or drugs required for the patient on your return. 2.6.4 If there is going to be a delay in getting the Retrieval Team and ambulance to the Quay in Cowes, telephone Red Funnel on 07976 844425 and they may be able to delay the Ferry, for a few minutes. 2.6.5 Otherwise telephone the Red Funnel ticketing office on 08448 449988 or 02380 724605 (out of hours) and rebook the return journey. 2.6.6 DO NOT rush to fit in with the ferry timetable.

Produced by: Jill Thistlethwaite

Date: January 2012

Approved by: Iain MacIntosh

Review date: January 2014