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[Intrahospital transport of critically ill children]
G Paret1, R Ben Abraham, O Yativ
1Dept. of Pediatric Intensive Care and of Anesthesiology, Sheba Medical Center, Tel Hashomer.
Insights
Intrahospital transport of critically ill children risks physiological deterioration, especially with mechanical ventilation or amines. Longer transport times and higher PRISM scores also increase these risks.
Area of Science:
- Pediatric Intensive Care
- Transport Medicine
- Critical Care
Context:
- Intrahospital transportation is a critical procedure for critically ill children requiring movement within a healthcare facility.
- Assessing risks associated with these transports is vital for patient safety and optimizing care delivery.
Purpose:
- To prospectively evaluate intrahospital transportation of critically ill children.
- To identify factors contributing to the risk of adverse events during transport.
Summary:
- 33 critically ill children (3 days to 15 years) underwent intrahospital transport.
- Mechanical ventilation (66.6%) and amine use (30.3%) were common. Equipment mishaps (36.3%) and physiological deterioration (30.3%) occurred.
- Amines, mechanical ventilation, longer transport time, and high PRISM scores were associated with physiological deterioration.
Impact:
- Findings highlight key risk factors during pediatric intrahospital transport.
- Informs strategies to mitigate adverse events and improve patient outcomes during critical care transport.
Abstract:
Prospective evaluation of intrahospital transportation of 33 critically ill children to and from the pediatric intensive care unit was conducted over the course of a month. Factors contributing to risk of transport were assessed. There were 33 children (25 boys and 8 girls), 3 days to 15 years of age. Reasons for admission included: disease and trauma in 19, and status post operation in 11. The pretransport PRISM score was 4.84. 22 children (66.6%) were being mechanically ventilated and 10 (30.3%) were being treated with amines. Transport time ranged from 8-150 minutes. 15 of the transports (45.4%) were urgent and a special intensive care team escorted 22 (66.6%). Equipment mishaps and physiological deterioration occurred in 12 (36.3%) and 11 (30.3%) of the cases, respectively. The use of amines, mechanical ventilation, longer transport time and high PRISM score were all associated with physiological deterioration on transport.