title: Cerebral Oxygenation and Acceleration in Pediatric and Neonatal Interfacility Transport.
abstract: OBJECTIVE
  The purpose of this study is to measure peak acceleration forces during interfacility transport; examine whether drops in cerebral oxygenation occurred; and test the associations between cerebral oxygenation, acceleration, and patient positioning.
  
  
  METHODS
  A cerebral oximeter (INVOS-5100C; Somanetics, Minneapolis, MN) monitored regional saturation of oxygen (rSO2 [cerebral oxygenation]) in pediatric and neonatal patients (N = 24) transported between facilities by ground ambulance, helicopter, or fixed wing aircraft. An accelerometer (GP1; SENSR, Georgetown, TX) bolted to the isolette or gurney recorded z-axis (aligned with the spine) accelerations.
  
  
  RESULTS
  The z-axis peak accelerations (absolute values of g) by transport type were as follows: ground ambulance takeoff mean = 0.16 and landing mean = 0.08, helicopter takeoff mean = 0.16 and landing mean = 0.05, fixed wing aircraft takeoff mean = 0.14 and landing mean = 0.20. During takeoff, 2 of 7 patients in the head-to-front of vehicle position experienced rSO2 drop. During landing, 4 of 13 patients in the head-to-back of vehicle position experienced rSO2 drop. There were no significant associations of rSO2 drop during takeoff and landing with patient positioning or with z-axis peak acceleration.
  
  
  CONCLUSIONS
  Acceleration forces of pediatric and neonatal interfacility transport are small and comparable in magnitude. The relationship between rSO2 drop and patient positioning was not significant in this pilot study.
authors.affiliation: Division of Emergency and Transport Medicine, Children's Hospital Los Angeles, CA, USA.
authors.forename: Michael E
authors.initials: ME
authors.lastname: Valente
authors.affiliation: Division of Emergency and Transport Medicine, Children's Hospital Los Angeles, CA, USA.
authors.forename: Judy A
authors.initials: JA
authors.lastname: Sherif
authors.affiliation: Southern California Clinical and Translational Science Institute, Children's Hospital Los Angeles and University of Southern California, Los Angeles, CA, USA.
authors.forename: Colleen G
authors.initials: CG
authors.lastname: Azen
authors.affiliation: Division of Emergency and Transport Medicine, Children's Hospital Los Angeles, CA, USA.
authors.forename: Phung K
authors.initials: PK
authors.lastname: Pham
authors.affiliation: Division of Emergency and Transport Medicine, Children's Hospital Los Angeles, CA, USA; Department of Pediatrics, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA. Electronic address: clowe@chla.usc.edu.
authors.forename: Calvin G
authors.initials: CG
authors.lastname: Lowe
mesh_terms: D000054:Acceleration / Q000009:adverse effects*; D017732:Air Ambulances; D001921:Brain / Q000098:blood supply*; D001923:Brain Chemistry; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D010092:Oximetry; D010100:Oxygen / Q000032:analysis; D010865:Pilot Projects; D011187:Posture; D011446:Prospective Studies; D014187:Transportation of Patients / Q000379:methods*
chemical_list: D010100:Oxygen