title: Transfer of pediatric trauma patients to a tertiary pediatric trauma centre: appropriateness and timeliness.
abstract: OBJECTIVE
  To study the appropriateness of, and time taken, to transfer pediatric trauma patients in New South Wales to The Children's Hospital at Westmead (CHW), a pediatric trauma center.
  
  
  METHODS
  All trauma patients transferred to CHW from June 2003 to July 2004 were included in the study. Indications and time periods relevant to the transfer of the patient from the referring institute were retrieved and analyzed. Pediatric and adult retrieval services were compared.
  
  
  RESULTS
  Three hundred ninety-eight patients were transferred to CHW, of whom 332 were from the metropolitan region. Falls and burns were the commonest mechanism of injury. Burn was the commonest indication for transfer (107 of 398). Mean Injury Severity Score was eight. Nearly half the patients had minor injuries (Injury Severity Score<9). Patients spent an average of 5 hours at the referring hospital. Pediatric retrieval ambulances had significantly longer mean transfer times than did nonpediatric ambulance services with a total time spent of about 2.64 hours versus 1.30 hours, respectively. For aeromedical transfers, on the other hand, the difference between pediatric retrieval services and nonpediatric air ambulances was not significant.
  
  
  CONCLUSIONS
  The majority of the patients transferred had minor injuries. Pediatric trauma patients spend considerable time in their referring hospitals. Pediatric retrieval services appear to take significantly longer to transfer patients than nonpediatric ambulance transfers even after allowing for patient age and injury severity. Although this did not result in mortality or morbidity, there appears to be considerable scope for a reduction in transfer times through better coordination of these services.
authors.affiliation: Department of Academic Surgery and Trauma, The Children's Hospital at Westmead, Sydney, Australia. ss@chw.edu.au
authors.forename: S V S
authors.initials: SV
authors.lastname: Soundappan
authors.forename: Andrew J A
authors.initials: AJ
authors.lastname: Holland
authors.forename: Fiona
authors.initials: F
authors.lastname: Fahy
authors.forename: Patricia
authors.initials: P
authors.lastname: Manglik
authors.forename: Lawrence T
authors.initials: LT
authors.lastname: Lam
authors.forename: Daniel T
authors.initials: DT
authors.lastname: Cass
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D005260:Female; D006785:Hospitals, University; D006801:Humans; D007223:Infant; D015601:Injury Severity Score; D008297:Male; D009517:New South Wales; D010360:Patient Transfer / Q000706:statistics & numerical data*; D011446:Prospective Studies; D013997:Time Factors; D014193:Trauma Centers; D014947:Wounds and Injuries / Q000628:therapy*