HIGH RISK PAEDIATRIC INTER-HOSIPTAL TRANSPORT

Abstract

While neonatal transport is widespread and relatively standardized, paediatric transport is newer with more varied requirements for optimal management, equipment and personnel. Over a recent 14 month period (ending 30/9/86), our center coordinated inter-hospital transfer of 400 children.

Thirty percent were neonates, with a total of 59% less than 1 year, 19% between 1-4 years, 12% between 4-8 years, and 10% older than 8 years. Major diagnoses were trauma, infection, seizures, hypoxic-ischemic injury and congenital anomalies. Eighty-two percent of the calls were emergent and 60% of children required admission to the Intensive Care Unit. Six (1.5%) died during resuscitation prior to transfer, and no children died in transit. Sixty-three percent were transported by air.

Problems occurred on 20% of transports, of which 8% were predicted (due to the severity of illness, equipment limitation or poor weather). Significant problems occurred more frequently when patients were escorted by adult paramedics as compared to infant trained crews. Thirty percent of patients required major interventions by the transport team for stabilization prior to transfer and 5% required major interventions enroute.

The logistics of coordinating paediatric emergency transport are complex because of the diversity of diagnoses, physical size, medication and equipment, requiring dedicated physician staff with a transport team trained to manage paediatric patients.

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