title: Morbidity and severity of illness during interhospital transfer: impact of a specialised paediatric retrieval team.
abstract: OBJECTIVE
  To evaluate the morbidity and severity of illness during interhospital transfer of critically ill children by a specialised paediatric retrieval team.
  
  
  METHODS
  Prospective, descriptive study.
  
  
  METHODS
  Hospitals without paediatric intensive care facilities in and around the London area, and a paediatric intensive care unit at a tertiary centre.
  
  
  METHODS
  51 critically ill children transferred to the paediatric intensive care unit.
  
  
  METHODS
  Adverse events related to equipment and physiological deterioration during transfer. Paediatric risk of mortality score before and after retrieval. Therapeutic intervention score before and after arrival of retrieval team.
  
  
  RESULTS
  Two (4%) patients had preventable physiological deterioration during transport. There were no adverse events related to equipment. Severity of illness decreased during stabilisation and transport by the retrieval team, suggested by the difference between risk of mortality scores before and after retrieval (P < 0.001). The median (range) difference between the two scores was 3.0 (-6 to 17). Interventions during stabilisation by the retrieval team increased, demonstrated by the difference between intervention scores before and after retrieval, median (range) difference between the two scores being 6 (-8 to 38) (P < 0.001).
  
  
  CONCLUSIONS
  Our study indicates that a specialised paediatric retrieval team can rapidly deliver intensive care to critically ill children awaiting transfer. Such children can be transferred to a paediatric intensive care unit with minimal morbidity and mortality related to transport. There was no deterioration in the clinical condition of most patients during transfer.
authors.affiliation: Department of Paediatrics, St Mary's Hospital, London.
authors.forename: J
authors.initials: J
authors.lastname: Britto
authors.forename: S
authors.initials: S
authors.lastname: Nadel
authors.forename: I
authors.initials: I
authors.lastname: Maconochie
authors.forename: M
authors.initials: M
authors.lastname: Levin
authors.forename: P
authors.initials: P
authors.lastname: Habibi
mesh_terms: D002648:Child; D002675:Child, Preschool; D016638:Critical Illness / Q000628:therapy; D006801:Humans; D015278:Intensive Care Units, Pediatric; D008131:London / Q000453:epidemiology; D009017:Morbidity; D010348:Patient Care Team; D010360:Patient Transfer; D011446:Prospective Studies; D012720:Severity of Illness Index