Optimal escort for interhospital transport of pediatric emergencies

Area of Science:

• Pediatric critical care
• Emergency medicine
• Transport medicine

Background:

• Critically ill or injured children require specialized care during interfacility transport.
• Secondary insults can complicate patient outcomes during pediatric transport.
• The role of escort training in preventing adverse events is not well-defined.

Purpose of the Study:

• To determine the incidence of secondary insults in critically ill children based on the training level of their transport escorts.
• To evaluate the impact of specialized pediatric transport training on patient safety during critical care transfers.

Main Methods:

• Retrospective chart review of 130 seriously ill or injured children transported to tertiary intensive care units.
• Categorization of transport escorts into three groups based on training: no specialized training, specialized training alone, and specialized training with a physician.
• Analysis of the incidence of secondary insults in relation to escort qualifications.

Main Results:

• Children transported by escorts with no specialized pediatric training incurred 72% of all secondary insults.
• Escorts with specialized training alone were associated with 20% of insults.
• Escorts accompanied by a tertiary care physician incurred only 8% of secondary insults, indicating a significant protective effect.

Conclusions:

• Specialized pediatric transport training and physician accompaniment are associated with a substantial reduction in secondary insults.
• Transport coordinators should rigorously assess the qualifications and experience of all transport team members.
• Prioritizing trained personnel and physician involvement is essential for optimizing care during high-risk pediatric transports, especially during air transfers or for severely ill children.