Published online June 29, 2009
PEDIATRICS Vol. 124 No. 1 July 2009, pp. 40-48 (doi:10.1542/peds.2008-0515)
This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow View responses
Right arrow Alert me when this article is cited
Right arrow Alert me when eLetters are posted
Right arrow Alert me if a correction is posted
Right arrow Citation Map
Services
Right arrow E-mail this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to My File Cabinet
Right arrow Download to citation manager
Right arrowRequest Permissions
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via CrossRef
Right arrow Citing Articles via Web of Science (1)
Google Scholar
Right arrow Articles by Orr, R. A.
Right arrow Articles by Watson, R. S.
PubMed
Right arrow PubMed Citation
Right arrow Articles by Orr, R. A.
Right arrow Articles by Watson, R. S.
Related Collections
Right arrow Office Practice
Social Bookmarking
Add to CiteULike   Add to Connotea   Add to Del.icio.us   Add to Digg   Add to Facebook   Add to Reddit   Add to Technorati   Add to Twitter  
What's this?

ARTICLE

Pediatric Specialized Transport Teams Are Associated With Improved Outcomes

Richard A. Orr, MDa,b,c, Kathryn A. Felmet, MDa,b,c, Yong Han, MDd, Karin A. McCloskey, MDe,{dagger}, Michelle A. Dragotta, RNc, Debra M. Bills, RNc, Bradley A. Kuch, RRTc and R. Scott Watson, MD, MPHa,b,c,f

a Departments of Critical Care Medicine
b Pediatrics
f Clinical Research, Investigation, and Systems Modeling of Acute Illness Laboratory, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
c Department of Critical Care Medicine/Transport, Children's Hospital of Pittsburgh, Pittsburgh, Pennsylvania
d Department of Pediatrics and Communicable Diseases, Division of Pediatric Critical Care Medicine, University of Michigan Health System, Ann Arbor, Michigan
e Department of Pediatric Emergency Medicine, University of Rochester Medical Center, Rochester, New York

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.

Key Words: interfacility transport • pediatric • outcome

Abbreviations: PRISM—Pediatric Risk of Mortality • EMS—emergency medical services • OR—odds ratio • RR—relative risk • CI—confidence interval • CHP—Children's Hospital of Pittsburgh • CAMTS—Commission on Accreditation of Medical Transport Systems

Accepted Nov 3, 2008.


Add to CiteULike CiteULike   Add to Connotea Connotea   Add to Del.icio.us Del.icio.us   Add to Digg Digg   Add to Facebook Facebook   Add to Reddit Reddit   Add to Technorati Technorati   Add to Twitter Twitter    What's this?


This article has been cited by other articles:


Home page
 JWatch Emergency Med.Home page
Better Outcomes with a Specialized Pediatric Transport Team
Journal Watch Emergency Medicine, August 21, 2009; 2009(821): 4 - 4.
[Full Text]

Home page
 PediatricsHome page
M. L. McPherson and J. M. Graf
Speed Isn't Everything in Pediatric Medical Transport
Pediatrics, July 1, 2009; 124(1): 381 - 383.
[Full Text] [PDF]

eLetters:

Read all eLetters

Pediatric Specialized Transport Teams And Improved Outcomes: are we seeing the full picture?
Padmanabhan Ramnarayan, et al.
Pediatrics Online, 19 Aug 2009 [Full text]