Variables predicting the need for a pediatric critical care transport team.
To determine when a pediatric critical care transport team is required to transport a patient to a referral center, this cross-sectional study evaluated 369 consecutive pediatric transports by stepwise multiple logistic regression analysis of six variables: age, vital signs, seizure activity, current endotracheal intubation, respiratory distress, and respiratory diagnosis. Models were developed for three outcome variables: 1) Major procedures were required in 8.9% of cases. The predicted probability of needing a major procedure was increased for intubated patients (probability of 12.9%), patients less than 1 year of age with unstable vital signs (12.9%), and patients meeting both these criteria (23.2%). 2) A posttransport assessment of need for a physician on the team was positive in 43% of cases. The probability of needing a physician was increased for intubated patients (probability of 68.8%), patients less than 1 year of age with unstable vital signs (58.7%), and patients meeting both these criteria (79.9%). 3) Category 1 drugs, ie, medications requiring ICU monitoring, were used in 19% of transports. The probability of this occurring was increased for intubated patients with stable vital signs (probability of 24.7%) and for intubated patients with unstable vital signs (41.4%). None of the other pretransport variables, alone or in pairs, was a significant predictor of any of the three outcome variables. The data indicate that intubation, age, and vital sign status can be used in predicting whether a transport team is needed.
McCloskey
K A
KA
Department of Pediatrics, University of Alabama School of Medicine, Birmingham.
Faries
G
G
King
W D
WD
Orr
R A
RA
Plouff
R T
RT
D000367:Age Factors; D003422:Critical Care; D003430:Cross-Sectional Studies; D006801:Humans; D007223:Infant; D007442:Intubation, Intratracheal; D010348:Patient Care Team; D010820:Physicians; D012044:Regression Analysis; D012131:Respiratory Insufficiency; D012640:Seizures; D014187:Transportation of Patients