Pediatric specialized transport teams are associated with improved outcomes

Richard A. Orr, Kathryn A. Felmet, Yong Han, Karin A. McCloskey, Michelle A. Dragotta, Debra M. Bills, Bradley A. Kuch, Scott Watson

Research output: Contribution to journalArticlepeer-review

180 Scopus citations

Abstract

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%). CONCLUSION: 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.

Original languageEnglish (US)
Pages (from-to)40-48
Number of pages9
JournalPediatrics
Volume124
Issue number1
DOIs
StatePublished - Jul 2009
Externally publishedYes

Keywords

  • Interfacility transport
  • Outcome
  • Pediatric

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health

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