Pediatric critical care transport--the safety of the journey: a five-year review of vehicular collisions involving pediatric and neonatal transport teams.
OBJECTIVE
To determine the frequency and consequences of vehicular crashes among dedicated pediatric and neonatal transport teams.


METHODS
A three-page questionnaire was sent to the transport teams of National Association of Children's Hospitals and Related Institutions (NACHRI) member hospitals. The survey instrument consisted of three sections. The first section requested demographic information about the team and asked the team to report any vehicular collisions or incidents in the previous five years. The second section was directed at teams that did not report collisions or incidents and asked the team to identify potential reasons for their safety record. The third section was directed to those teams reporting collisions or incidents and asked about the causes and consequences of these events.


RESULTS
Ninety of 153 (59%) surveys were returned. Thirty-eight of the 90 teams (42%) reported at least one collision in the previous five years. A total of 66 collisions were reported (nine aircraft crashes and 57 ambulance collisions). The number of collisions was not related to the total number of transports performed by the team. Most teams attributed the collisions to errors on the part of a team member or to the actions of a third party. Collisions resulted in eight deaths, ten cases of moderate to severe injury, and 28 minor injuries to patients, health care workers, and/or the ambulance crew. All deaths resulted from aircraft crashes. Additionally, there were operational impacts upon the teams. These included missed workdays and disability on the part of team members and changes in team practices. Collision-free teams attributed their safety record to specific policies of the team and/or the vehicle owner or vendor and to luck.


CONCLUSIONS
Collisions/crashes among pediatric transport teams are unusual. However, they have resulted in deaths, injuries, and disability. Collisions/crashes appear to be caused by the actions of a team member and/or those of third parties. Specific safety policies on the part of the team and/or vehicle owner or provider may prevent or decrease collisions/crashes.
King
Brent R
BR
Department of Emergency Medicine, University of Texas Houston Medical School, 77030, USA. brent.king@uth.tmc.edu
Woodward
George A
GA
D000060:Accidents, Aviation / Q000401:mortality / Q000706:statistics & numerical data*; D000062:Accidents, Occupational / Q000706:statistics & numerical data*; D000063:Accidents, Traffic / Q000401:mortality / Q000706:statistics & numerical data*; D017732:Air Ambulances / Q000706:statistics & numerical data; D000552:Ambulances / Q000706:statistics & numerical data*; D015984:Causality; D002648:Child; D003422:Critical Care; D006302:Health Services Research; D006776:Hospitals, Pediatric; D006801:Humans; D007231:Infant, Newborn; D010372:Pediatrics; D012308:Risk Management; D017751:Safety Management; D014187:Transportation of Patients; D014481:United States