Pediatric specialized transport teams are associated with improved outcomes.
OBJECTIVE
The goal was to test the hypothesis that interfacility transport performed by a pediatric critical care specialized team, compared with nonspecialized teams, would be associated with improved survival rates and fewer unplanned events during the transport process.


METHODS
A single-center, prospective, cohort study was performed between January 2001 and September 2002. A total of 1085 infants and children at referral community hospitals with requests for retrieval by the Children's Hospital of Pittsburgh transport team were studied; 1021(94%) were transported by a specialty team and 64 (6%) by nonspecialized teams. Unplanned events during the transport process and 28-day mortality rates were assessed.


RESULTS
Unplanned events occurred for 55 patients (5%) and were more common among patients transported by nonspecialized teams (61% vs 1.5%). Airway-related events were most common, followed by cardiopulmonary arrest, sustained hypotension, and loss of crucial intravenous access. After adjustment for illness severity, only the use of a nonspecialized team was independently associated with an unplanned event, and death was more common among patients transported by nonspecialized teams (23% vs 9%).


CONCLUSIONS
Transport of critically ill children to a pediatric tertiary care center can be conducted more safely with a pediatric critical care specialized team than with teams lacking specific training and expertise in pediatric critical care and pediatric transport medicine.
Orr
Richard A
RA
Department of Critical Care Medicine, Systems Modeling of Acute Illness Laboratory, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA. orrra@ccm.upmc.edu
Felmet
Kathryn A
KA
Han
Yong
Y
McCloskey
Karin A
KA
Dragotta
Michelle A
MA
Bills
Debra M
DM
Kuch
Bradley A
BA
Watson
R Scott
RS
D017732:Air Ambulances / Q000458:organization & administration*; D002648:Child; D002675:Child, Preschool; D003422:Critical Care / Q000458:organization & administration*; D016638:Critical Illness; D006776:Hospitals, Pediatric; D006801:Humans; D007223:Infant; D016015:Logistic Models; D017063:Outcome Assessment, Health Care; D010348:Patient Care Team; D010360:Patient Transfer / Q000458:organization & administration*; D010414:Pennsylvania; D011446:Prospective Studies; D000078329:Workforce