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Use of a physiologic scoring system during interhospital transport of pediatric patients
B Gunnarsson1, C M Heard, A T Rotta
1Department of Anesthesia, Children's Hospital of Buffalo, Buffalo, NY 14222, USA. cheard@acsu.buffalo.edu
Insights
Physiologic deterioration in critically ill children during transport was similar for air and ground ambulances. A simple scoring system can be used for quality assurance in pediatric interhospital transport.
Area of Science:
- Pediatric critical care medicine
- Emergency medical services
- Transport medicine
Background:
- Interhospital transport of critically ill children is common.
- Assessing patient stability during transport is crucial for quality care.
- Air and ground ambulances are used for pediatric patient transfers.
Purpose of the Study:
- To determine the incidence of physiologic deterioration in critically ill and injured pediatric patients during interhospital transport.
- To compare adverse events and physiologic changes between air and ground ambulance transports.
- To evaluate a simple physiologic scoring system for quality assurance.
Main Methods:
- Prospective, descriptive study of 100 pediatric patients.
- Patients transported from regional hospitals to a pediatric tertiary care center.
- Physiologic scores assessed at referral, departure, and arrival.
Main Results:
- Incidence of significant physiologic deterioration was 5.6% (ground) vs. 3.4% (air).
- Critical events occurred in 15% of ground and 31% of air ambulance transports.
- No significant difference in adverse events or deterioration between transport modes.
Conclusions:
- No difference in adverse events or physiologic deterioration between air and ground ambulance transports for critically ill children.
- The chosen physiologic scoring system is simple and effective for quality assurance.
- Further research may explore specific patient populations or transport conditions.
Objective:
To determine the incidence of physiologic deterioration in critically ill and injured pediatric patients during interhospital transport with air and ground ambulance
Design:
Prospective, descriptive study
Setting:
All children were treated in regional hospitals and then transported to a pediatric tertiary care center.
Patients:
Children (n = 100) with a median age of 1.4 years (range 1 week to 18 years)
Main Results:
Three sets of physiologic scores were calculated: at the time of referral, on departure from the referring hospital, and arrival at the tertiary care center. The incidence of significant physiologic deterioration based on the calculated physiologic scores was 5.6% (n = 4) during ground and 3.4% (n = 1) during air ambulance transports. Critical events occurred in 15% of ground and 31% of air ambulance transports.
Conclusion:
No difference existed in the incidence of adverse events or physiologic deterioration when air ambulance transports were compared with ground ambulance transports for critically ill children by our team. The physiologic scoring system we chose is simple and easy to use for quality assurance.
