Specialist team retrieval of head injured patients: fact, fiction, or formula?
OBJECTIVE
This feasibility study aimed to determine the maximum theoretical distance the Edinburgh Paediatric Retrieval Team (EPRT) could travel to retrieve head injured children without additional delay in reaching definitive care.


METHODS
A prospective audit was conducted over 2 years to determine the current practice for paediatric head injury transfers (stabilisation, referral, and transfer time) undertaken by primary hospital staff, and the performance (mobilisation and travel time) of the EPRT. A novel formula was devised and used to determine the theoretical maximum radius within which the EPRT could reach a referring hospital during their stabilisation of head injured patients.


RESULTS
During the study period, 27 head injured patients were transferred to our unit by road and the EPRT conducted 194 road retrievals. The median stabilisation time for the head injured patients was 3.6 h. Median time to refer these patients to neurosurgical services was 1 h after presenting to primary hospitals. Median mobilisation time for EPRT was 1 h. Using our novel formula, 67 miles was the theoretical maximum radius within which the EPRT could reach a referring hospital during their stabilisation of head injured patients.


CONCLUSIONS
Specialist team retrieval of paediatric head injury is a possibility, but not without significant organisational changes such as availability of second teams, early referral of patients and utilisation of the mobilisation time as a cancellation window. Our novel formula offers other teams a starting point to assess their own performance and to develop services.
Emergency Department, The Children's Hospital at Westmead, Locked Bag 4001, Parramatta, Sydney, NSW, 2145, Australia. clared1@chw.edu.au
Clare
C
Dieppe
T Y Milly
TY
Lo
Jillian
J
McFadzean
David A
DA
Rowney
D002648:Child; D054869:Clinical Audit; D006259:Craniocerebral Trauma / Q000453:epidemiology* / Q000628:therapy*; D005240:Feasibility Studies; D006801:Humans; D010348:Patient Care Team; D010360:Patient Transfer / Q000706:statistics & numerical data; D011446:Prospective Studies; D013997:Time Factors; D006113:United Kingdom / Q000453:epidemiology