Peer Support for a Specialty Critical Care Transport Team

First responders experience higher rates of psychological distress than the general population, driven by repeated exposure to traumatic events and limited recovery time. Members of neonatal and pediatric critical care transport teams face additional cumulative stressors related to high-acuity patients and emotionally challenging transports. This study describes the development, implementation, and utilization of a peer-led support program within a hospital-based neonatal and pediatric critical care transport service.

Following a 2019 internal survey that identified a preference for peer-based emotional support, the Children's Mercy Critical Care Transport Team implemented a structured peer support program. Peer Support Persons (PSPs) were selected from a multidisciplinary transport team and completed standardized initial and ongoing training. Peer support was accessed through self-referral, leadership referral, and a confidential QR code (Quick Response Code) request system. Minimal, non-identifiable encounter data were tracked in a secure database. Descriptive analysis was used to evaluate program utilization from March 2023 to August 2025.

During the study period, 209 peer support encounters were documented, including 11 formal debriefings and 199 informal interactions. Encounters involved registered nurses, respiratory therapists, emergency medical technicians, communication specialists, and other team members, most of which were related to difficult transports, patient deaths, and emotional distress. Program utilization increased over time, demonstrating the integration of peer support into routine team culture. Staff feedback was consistently positive, highlighting the value of timely, confidential, peer-led support.

A structured, confidential, peer-led support program is feasible and sustainable in a neonatal and pediatric critical care transport setting. This model promotes resilience, reduces stigma, and may serve as a framework for similar first-responder programs.