Related Experiment Videos
A Descriptive Analysis of Pediatric Transports Throughout the U.S. Indo-Pacific Command
Ashley E Sam1,2, Mitchell T Hamele3,4, Renée I Matos1,2,4
1San Antonio Uniformed Services Education Consortium, Department of Pediatrics, Brooke Army Medical Center, JBSA-Fort Sam Houston, TX 78234, USA.
Insights
Pediatric patient transports in the U.S. Indo-Pacific Command (INDOPACOM) are frequent, with nearly one in six requiring specialized care. Neonates and infants comprised a significant portion, highlighting the need for dedicated pediatric transport teams and equipment.
Area of Science:
- Military Medicine
- Pediatric Transport
- Epidemiology
Background:
- The U.S. Indo-Pacific Command (INDOPACOM) serves a large population, including dependents requiring pediatric care.
- Existing infrastructure offers routine pediatric care, but subspecialty, surgical, and intensive care necessitate patient movement.
- Current air evacuation teams often lack pediatric-specific expertise and equipment.
Purpose of the Study:
- To describe the epidemiology of pediatric patient transport missions within INDOPACOM.
- To identify the characteristics and needs of pediatric patients requiring evacuation.
Main Methods:
- Retrospective review of pediatric patients (<18 years) transported within INDOPACOM.
- Data extracted from the Transportation Command Regulating and Command and Control Evacuation System (TRAC2ES) database (June 2008-June 2018).
- Patients categorized into neonatal, infant, young child, and older child age groups.
Main Results:
- Children constituted 16.3% of all transports (687/4,217).
- Neonates and infants represented nearly one-third of pediatric transports.
- Respiratory, cardiac, and abdominal conditions were most common; older children showed a higher incidence of psychiatric diagnoses.
- Mechanical ventilation was required for 17.2% of pediatric patients, predominantly neonates.
Conclusions:
- Pediatric patients, particularly neonates and infants, represent a substantial proportion of aeromedical evacuations in INDOPACOM.
- A significant percentage of pediatric transports require advanced interventions like mechanical ventilation.
- Findings underscore the critical need for specialized pediatric-trained transport teams and tailored equipment to ensure optimal patient outcomes.
Background:
The U.S. Indo-Pacific Command (INDOPACOM) has over 375,000 military personnel, civilian employees, and their dependents. Routine pediatric care is available in theater, but pediatric subspecialty, surgical, and intensive care often require patient movement. Transfer is frequently performed by military air evacuation teams and intermittently augmented by civilian services. Pediatric care requires special training and equipment, yet most transports are staffed by non-pediatric specialists. We seek to describe the epidemiology of pediatric transport missions in INDOPACOM.
Methods:
A retrospective review of all patients less than 18 years old transported within INDOPACOM and logged into the Transportation Command Regulating and Command and Control Evacuation System (TRAC2ES) database from June 2008 through June 2018 was conducted. Data are reported using descriptive statistics. Patients were categorized into four age groups: neonatal (<31 days), infant (31-364 days), young children (1 to <8 years), and older children (8-17 years).
Results:
During the study period, 687 out of 4,217 (16.3%) transports were children. Median age was 4 years (interquartile range 6 months to 8 years) and 654 patients (95.2%) were transported via military fixed-wing aircraft. There were 219 (31.9%) neonates, 162 (23.6%) infants, 133 (19.4%) young children, and 173 (25.2%) older children. Most common diagnoses encountered were respiratory, cardiac, or abdominal, although older children had a higher percentage of psychiatric diagnoses (28%). Mechanical ventilation was used in 118 (17.2%) patients, and 75 (63.6%) of these patients were neonates.
Conclusions:
Within TRAC2ES, nearly one in six encounters were patients aged <18 years, with neonates or infants representing nearly one of three pediatric encounters. Slightly more than one in six pediatric patients required intubation for transport. The data suggest the need for appropriately trained transport teams and equipment be provided to support these missions.