title: International medical evacuation in children: a primary care pediatric clinic's 3-year experience.
abstract: BACKGROUND
  The decision whether to immediately evacuate children who have become ill is a challenge for pediatricians working in countries with limited medical resources. The aim of this study is to describe the injuries and diseases that required evacuation of children from our clinics in Ho Chi Minh City and Hanoi to tertiary critical care hospitals over a 3-yr period.
  
  
  METHODS
  A retrospective chart review was performed of all patients aged less than 17 yr who underwent an international medical evacuation between April 1, 2006, and February 28, 2009. Patients were allocated to one of two groups: those requiring immediate aeromedical evacuation by air ambulance and those whose condition allowed nonurgent evacuation by commercial flight.
  
  
  RESULTS
  There were 19 international medical evacuations that were executed: 5 immediate aeromedical evacuations with air ambulance and 14 nonurgent evacuations using commercial flights. Immediate evacuations were undertaken to Thailand and Singapore to access pediatric cardiac surgery and intensive care facilities. Some evacuations were performed mainly at parental request.
  
  
  CONCLUSIONS
  Aeromedical evacuation requires a multidisciplinary approach and patient age, local resources, availability, location of resources, and parental preference are important factors to be considered. Effective communication is paramount and choice of transportation should be governed by pre-established policies and procedures if possible.
authors.affiliation: Department of Pediatric Emergency Medicine, The Hospital for Sick Children, Toronto, Ontario, Canada. nopasara73@hotmail.com
authors.forename: Miguel
authors.initials: M
authors.lastname: Glatstein
authors.forename: Jonathan
authors.initials: J
authors.lastname: Halevy
authors.forename: Yaron
authors.initials: Y
authors.lastname: Atzmon
authors.forename: Raphael J
authors.initials: RJ
authors.lastname: Kot
authors.forename: Dennis
authors.initials: D
authors.lastname: Scolnik
mesh_terms: D000293:Adolescent; D017732:Air Ambulances; D002648:Child; D002675:Child, Preschool; D003657:Decision Making; D003906:Developing Countries; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D011320:Primary Health Care; D012189:Retrospective Studies; D012846:Singapore; D013785:Thailand; D014187:Transportation of Patients / Q000379:methods*; D014744:Vietnam