Related Experiment Video
Updated: Sep 10, 2025
A Novel Rescue Technique for Difficult Intubation and Difficult Ventilation
Published on: January 17, 2011
Safety of transporting ventilated children by skilled personnel: A multicenter prospective study
Masahiro Nozawa1, Noriyuki Kaku2, Naoki Shimizu3
1Shiga General Hospital, Moriyama, Shiga, Japan.
Insights
Skilled pediatric transport teams significantly reduced adverse airway events in critically ill children on ventilators compared to unskilled teams. Specialized training and experience are crucial for safe interfacility patient transfers to pediatric intensive care units (PICUs).
Area of Science:
- Pediatric critical care medicine
- Transport medicine
- Patient safety
Background:
- Effective interfacility transport is vital for pediatric intensive care unit (PICU) patient outcomes.
- Evaluating personnel skill level impacts transport-related adverse events in ventilated pediatric patients.
Purpose of the Study:
- To compare adverse event rates during interfacility transport of pediatric patients on ventilators.
- To determine if skilled versus unskilled transport personnel influence patient safety outcomes.
Main Methods:
- Multicenter, prospective, observational cohort study of pediatric patients (<16 years) on ventilators.
- Classification of transport personnel as skilled (PICU/transport team experience) or unskilled.
- Investigation of adverse airway events, equipment/medication use, and neurological outcomes.
Main Results:
- Skilled personnel group (n=171) had significantly lower adverse airway events (9.9%) than the unskilled group (n=123, 26.0%).
- Skilled teams utilized end-tidal CO2 monitors, heat/moisture exchangers, and advanced medications more frequently.
- No significant differences in neurological outcomes (PCPC/FSS scores) between groups.
Conclusions:
- Specialized training and experience in pediatric transport are critical for minimizing adverse events.
- Developing transport systems with skilled personnel is essential for consolidating critically ill pediatric patients in PICUs.
Background:
A reliable interfacility transport system to safely transfer patients from the initial care setting to the pediatric intensive care unit (PICU) is essential to improve outcomes. This study aimed to evaluate whether using skilled versus unskilled personnel reduces the incidence of transport-related adverse events in the transportation of pediatric patients on ventilators in Japan.
Methods:
This multicenter, prospective, observational cohort study enrolled patients aged <16 years transported on ventilators to a Japanese PICU between August 2020 and July 2021. Transport personnel were classified as skilled (those working in PICUs or pediatric transport teams or with ≥1 year of experience in those facilities) or unskilled. Adverse airway events were investigated, and the equipment and medications used during transportation and neurological outcomes between the two groups were compared.
Results:
The study included 294 patients (171 with skilled, 123 with unskilled personnel). The skilled personnel had a lower incidence of adverse airway events than the unskilled group (9.9% vs. 26.0%, p < 0.001). The skilled personnel used end-tidal CO2 monitors, heat and moisture exchangers, analgesics, sedatives, and muscle relaxants more frequently than the unskilled personnel. No significant differences were observed between the two groups in the changes in Pediatric Cerebral Performance Category or Functional Status Scale scores from PICU admission to discharge.
Conclusions:
The results of this study highlight the importance of experience and specialized training in reducing the adverse events. Establishing a transport system with skilled personnel is important when considering measures to consolidate critically ill pediatric patients in PICUs.
Related Concept Videos
01:22Cardiopulmonary Resuscitation II: ACLS Airway Management
01:16Oxygen Delivering System II: Venturi Mask and Transtracheal Oxygen
Venturi Mask
The Venturi mask, named after the Venturi effect, is designed to deliver precise oxygen concentrations. It consists of a large tube with an oxygen inlet that narrows down, causing a pressure drop that pulls air in through adjustable side ports. The mask is a lightweight,...
01:23Mechanical Ventilation II: Invasive Ventilation
Negative-Pressure Ventilators
Negative-pressure ventilators create a vacuum around the chest or body to draw air into the lungs, simulating breathing. This method does not require an...
01:23Tracheostomy Suctioning II: Procedure
01:29Mechanical Ventilation I: Indication and Settings
01:26Tracheostomy Suctioning I: Pre-Procedural Steps
Equipment Required
First, gather all necessary equipment: a sterile suction catheter, a sterile disposable container, sterile gloves, a towel or...