[Prevention of complications in the air transport of the critically ill pediatric patient between hospitals].
OBJECTIVE
To analyze the rate of complications recorded during patient transport after applying a stabilization protocol in the sending hospital, defined by a paediatric critical patients air transport unit.


METHODS
We retrospectively analyzed the transfers made by the air unit of our hospital over a 5 years period. Patients with respiratory failure, hemodynamic compromise, or neurological involvement were identified. The stabilization protocol prior to transport is described. Operations performed during stabilization period, as well as during the transfer are quantified. Complications during transport are recorded and classified into major and minor ones.


RESULTS
A total of 388 patients were transferred, of which 207 had respiratory failure, 124 neurological disorders, and 102 with hemodynamic instability. During the stabilization period, 295 patients required oxygen and 161 mechanical ventilation. A total of 14 pleural drains, 397 peripheral lines and 97 central lines were placed. Vasoactive drugs were administered on 92 occasions and anticonvulsants in 41. We have performed 24 cardiopulmonary resuscitation, and 2 patients died before the move, and one required surgery. Twenty major complications have been recorded during transfer (6 neurological, 13 hemodynamic, and 1 respiratory), and 69 minor complications (14 neurological, 29 hemodynamic and 26 respiratory). One patient died.


CONCLUSIONS
Compliance with defined stabilization standards led to a high rate of interventions during the preparation phase. On the other hand, a small number of complications occurred during transport: only 5.1% of the patients showed any serious complication. This low rate of complications is attributable to a correct stabilization carried out prior to transfer, and based on the standards adopted by the team.
Servicio de Pediatría, Hospital de la Santa Creu i Sant Pau, Universitat Autónoma de Barcelona, Barcelona, España.
E
E
Carreras-Gonzalez
Servicio de Pediatría, Hospital de la Santa Creu i Sant Pau, Universitat Autónoma de Barcelona, Barcelona, España. Electronic address: sbrio@santpau.cat.
S
S
Brió-Sanagustin
D000293:Adolescent; D017732:Air Ambulances; D002648:Child; D002675:Child, Preschool; D016638:Critical Illness; D004638:Emergency Treatment / Q000009:adverse effects; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D011322:Primary Prevention; D012189:Retrospective Studies; D014187:Transportation of Patients
Complicaciones durante el transporte; Complications during transport; Helicopter transportation; Paediatric transportation; Transporte en helicóptero; Transporte pediátrico