title: Redefining the golden hour in pediatric transport.
abstract: OBJECTIVE
  To emphasize the urgent need for research efforts and application of goal-directed therapy in the pediatric transport environment.
  
  
  METHODS
  Review of existing literature and commentary on current pediatric transport practices.
  
  
  CONCLUSIONS
  Pediatric transport has evolved significantly since its inception >2 decades ago. Advancements in technology and therapeutic interventions now afford an opportunity to extend intensive care into the transport environment. However, misapplication of the concept of the golden hour has led to a focus on speed of transfer to tertiary care facilities, often delaying early, goal-directed therapeutic interventions. If we are to further improve outcomes for critically ill children, we must extend early institution of goal-directed therapy into the pretertiary hospital setting and bring expertise to the child.
authors.affiliation: University of Arkansas for Medical Sciences, Department of Pediatrics, Arkansas Children's Hospital, Section of Critical Care Medicine, USA. StroudMichaelH@uams.edu
authors.forename: Michael H
authors.initials: MH
authors.lastname: Stroud
authors.forename: Parthak
authors.initials: P
authors.lastname: Prodhan
authors.forename: Michele M
authors.initials: MM
authors.lastname: Moss
authors.forename: K J S
authors.initials: KJ
authors.lastname: Anand
mesh_terms: D002648:Child; D016638:Critical Illness; D004632:Emergency Medical Services / Q000458:organization & administration*; D006801:Humans; D010360:Patient Transfer / Q000458:organization & administration*; D010372:Pediatrics; D013997:Time Factors