The Race Against Sepsis: Are Helicopters Always Necessary? A Single-Center Analysis at a Tertiary Pediatric Hospital

Although numerous studies have evaluated transport modes for pediatric trauma, few have addressed strategies for sepsis. This study evaluates whether ground versus rotor wing transport affects transport time, hospital length of stay (LOS), or mortality in pediatric patients with suspected sepsis.

We performed a retrospective chart review at a 255-bed tertiary children's hospital and level 1 trauma center (∼81,000 annual emergency department visits). Patients aged 0 to 18 years with a referring diagnosis of possible sepsis and transported by Pedi-Flite, a specialized neonatal/pediatric critical care team, between January 1, 2010, and January 1, 2020, were included; neonatal intensive care unit admissions were excluded. Data included demographics, transport time, fluid/antibiotic administration, vasopressor use, blood culture results, LOS, discharge disposition, and insurance status.

Of 87 patients, 63 were transported by ground and 24 by rotor wing. Baseline characteristics and outcomes did not differ significantly. Mean transfer time was 150 ± 80 minutes for ground and 210 ± 297 minutes for rotor (P = .40). Team arrival to the referring hospital was 72 ± 51 minutes for ground and 125 ± 296 minutes for rotor (P = .40). LOS was 10.78 days (ground) versus 9.22 days (rotor; P = .6), and survival was 97% (rotor) versus 90% (ground; P = .40). Most patients received intravenous fluids (97%) and antibiotics (95%), with no group differences in administration rates or mean volume (33.4 vs. 33.3 mL/kg; P = .77). Vasopressors were started during transport in 10% and by the receiving hospital in 63%. In addition, 12 patients (14%) were intubated. Blood cultures were obtained in 40%, with 17% positive; no differences were observed between the groups (all P > .30).

Transport mode was not associated with differences in care or outcomes for suspected pediatric sepsis. In regions with similar geography and dispatch logistics, ground transport by a specialized critical care team may provide equivalent outcomes to rotor wing.