Transport for paediatric intensive care. Measuring the performance of a specialist transport service

Abstract

Fifty children were referred for transport to a paediatric intensive care unit (PICU). Two scoring systems were used for the transfer process. A physiology score derived from the paediatric risk of mortality (PRISM) score was performed at referral, before transfer and on arrival on PICU. An interventions score based on the therapeutic intervention scoring system (TISS) was performed for interventions by the referring staff and by the transport team before and during transfer. Critical events during transport were recorded. Three children died at the referring hospital. Forty-seven were transported by the PICU team. No child died or suffered a major physiological deterioration or equipment related problem in transit. Physiology scores did not deteriorate during transfer. Referral physiology scores did not reliably predict the need for major therapeutic interventions by the transport team before transfer. Critically ill children may be transported safely by a specialist team.

Measuring the performance of an inter-hospital transport service

“…Along similar lines, the adequacy of stabilisation performed by the transport team may be indicated by repeated measurement of physiological scores at different time points during the transfer 23 24…”

Post–Cardiac Arrest Syndrome

“…For now, stabilization and transfer of pediatric postarrest patients to optimally equipped and staffed specialized pediatric facilities should be encouraged. 363,364 …”

Stabilisation of critically ill children at the district general hospital prior to intensive care retrieval: a snapshot of current practice

“…Currently, most transfers are performed by PICU retrieval teams because preventable adverse events have been shown to occur frequently when nonspecialist staff transport patients to tertiary centres 5–7. However, because it may take a retrieval team a median of 100–120 min to arrive at the patient's bedside, vital interventions required in the first few hours of stabilisation remain the responsibility of the referring hospital and cannot be deferred until the arrival of the retrieval team 8 9…”