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Vital Sign and Nursing Assessment Patterns in Emergency Transfers to the Intensive Care Unit
Olivia Post1,2, Eleanor Young1,2, Yin Zhang3
1Division of Pediatric Hospital Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio.
Hospital Pediatrics
|May 12, 2026
Summary
Pediatric patients needing emergency transfer (ET) to the intensive care unit (ICU) showed signs of hypoperfusion, including prolonged capillary refill, before transfer. Tachycardia was not a reliable indicator for predicting ET.
Area of Science:
- Pediatric critical care medicine
- Clinical informatics
- Patient safety
Background:
- Pediatric patients requiring emergency transfer (ET) to intensive care units (ICUs) face higher morbidity and mortality.
- Identifying early clinical indicators of deterioration is crucial for developing timely intervention tools.
Purpose of the Study:
- To analyze patterns of clinical deterioration in vital signs and nursing assessments.
- To compare data preceding emergency transfer (ET) versus non-ET to the ICU.
Main Methods:
- Retrospective case-cohort study at a quaternary pediatric hospital (2015-2018).
- Compared ET (n=78) vs. non-ET (n=166) patients.
- Analyzed vital signs and nursing assessments up to 16 hours pre-transfer.
Main Results:
- ET patients had lower mean arterial pressure at transfer and 8 hours prior.
- No significant differences in heart or respiratory rates were observed.
- Prolonged capillary refill was noted in ET patients starting 12 hours before transfer.
Conclusions:
- Pediatric ET patients exhibit hypoperfusion signs before transfer, independent of heart rate.
- Tachycardia alone is not a reliable predictor of emergency transfer.
- Integrating objective and subjective data is vital for situation-awareness tools.
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