High risk pediatric emergency air transport

Area of Science:

• Emergency Medicine
• Pediatric Critical Care
• Transport Medicine

Background:

• A retrospective review of Pediatric Emergency Air Transports (PEATs) at Massachusetts General Hospital was conducted.
• Data from November 1986 to December 1987 were analyzed, comparing PEATs with ground transports.
• Key factors examined included severity of illness, complications, and patient outcomes.

Purpose of the Study:

• To compare the characteristics and outcomes of Pediatric Emergency Air Transports (PEATs) with ground transports.
• To identify factors associated with survival in patients undergoing PEATs.

Main Methods:

• Severity of illness was quantified using the modified Denver Patient Status Category (DPSC) and Therapeutic Intervention Scoring System (TISS).
• The study included 35 PEATs (30 helicopter, 5 fixed-wing) and 96 ground transports.
• Statistical analysis was performed to compare patient groups and identify survival predictors.

Main Results:

• Patients in PEATs exhibited a significantly greater mean severity of illness compared to ground transport patients (PEAT DPSC: 4.23±1.06 vs. ground: 3.57±0.89, p=.0005).
• Higher mean illness severity (TISS scores) was associated with PEAT mortality (survivors: 19.1±11.4 vs. non-survivors: 44.3±9.5, p=.0001).
• No significant association was found between PEAT survival and the presence of an on-flight physician, transport delay/duration, age, sex, chronic illness, or intra-transport complications.

Conclusions:

• Pediatric Emergency Air Transports are reserved for higher-risk patients compared to those transported by ground.
• Illness severity is a critical factor in PEAT outcomes, independent of transport-specific or patient-demographic variables.