2008
DOI: 10.1097/pcc.0b013e318172da62
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Redefining the golden hour in pediatric transport

Abstract: Pediatric transport has evolved significantly since its inception >2 decades ago. Advancements in technology and therapeutic interventions now afford an opportunity to extend intensive care into the transport environment. However, misapplication of the concept of the golden hour has led to a focus on speed of transfer to tertiary care facilities, often delaying early, goal-directed therapeutic interventions. If we are to further improve outcomes for critically ill children, we must extend early institution of … Show more

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Cited by 36 publications
(26 citation statements)
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“…In the first place, our results might have been influenced by our decision to include only non-elective patients and to treat Saturdays, Sundays and public holidays as off-hours. We assumed that the concepts of the so-called golden hour and of early goal-directed therapy would apply most to non-elective PICU admissions [1, 2, 14]. Elective admissions, on the other hand, constituted only a small proportion of all off-hours admissions; most were an overrun of procedures scheduled for office hours, and had a low predicted mortality rate.…”
Section: Discussionmentioning
confidence: 99%
See 1 more Smart Citation
“…In the first place, our results might have been influenced by our decision to include only non-elective patients and to treat Saturdays, Sundays and public holidays as off-hours. We assumed that the concepts of the so-called golden hour and of early goal-directed therapy would apply most to non-elective PICU admissions [1, 2, 14]. Elective admissions, on the other hand, constituted only a small proportion of all off-hours admissions; most were an overrun of procedures scheduled for office hours, and had a low predicted mortality rate.…”
Section: Discussionmentioning
confidence: 99%
“…It is known that adequate care during the first hours is of major importance for the outcome of patients admitted to intensive care units (ICUs) [1, 2]. In many ICUs, however, there is no 24-h in-house attendance of senior staff.…”
Section: Introductionmentioning
confidence: 99%
“…9 Additional publications have shown the benefit of specialized teams, indicating improved care and better outcomes. 1,10,11 Specialized pediatric teams are trained and equipped to deliver definitive care outside tertiary care centers.…”
Section: Clinical Researchmentioning
confidence: 99%
“…2 Since then, research has increased and led to several publications relevant to clinical practice and improving the quality of care provided during transport. [9][10][11][12][13][14][15][16] The broad diversity of, practice differences, and geography served by programs across the United States continues to challenge collaborative research efforts. An organized transport research network designed to answer relevant clinical questions in a multicentered collaborative fashion is urgently needed.…”
Section: Clinical Researchmentioning
confidence: 99%
“…7,8 In addition, several studies have questioned the importance of the speed of transfer to a tertiary care center, again highlighting the importance of early patient assessment and intervention before the transfer of children. 9 Pediatric specialty teams are specifically designed to bring pediatric critical care expertise and to implement these early, goaldirected therapies to patients in referring facilities. With the emphasis now placed on stabilization of patients at the referring facility, it is recognized that a standard of care similar to that of a pediatric intensive care unit (ICU) is needed during both ground and air transport to regional pediatric centers.…”
mentioning
confidence: 99%