Emergency transport of critically ill children: stabilisation before departure

To provide up-to-date practical information, relevant to Australian conditions and practice, on stabilising the condition of critically ill children who need transport to a paediatric hospital.

Information on current resuscitation practice was sought from relevant original articles and reviews in the recent medical literature, from textbooks and monographs published in the last 10 years.

A recent study found that 47% of 100 children who needed emergency interhospital transfer experienced problems which should have been preventable by greater availability to referring doctors of information on pretransport stabilisation of critically ill children. Hypoventilation, hypoxaemia and hypotension are commonly found in critically ill children before transport, as are difficulties with endotracheal tube care, sedation and analgesia. Mild physiological disturbances are likely to become severe and life-threatening during transfer unless they are corrected before departure. Early discussion of the child's problems and the transfer plan with senior staff at the nearest paediatric intensive care unit may be helpful in planning the pre-transfer resuscitation.