Published online June 29, 2009
PEDIATRICS Vol. 124 No. 1 July 2009, pp. 381-383 (doi:10.1542/peds.2008-3596)
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COMMENTARY

Speed Isn't Everything in Pediatric Medical Transport

Mona L. McPherson, MD, MPH and Jeanine M. Graf, MD

Pediatric Critical Care, Baylor College of Medicine, Houston, Texas

Abbreviations: CAMTS—Commission on Accreditation of Medical Transport Systems

The first 20% of the full text of this article appears below.

Aesop's familiar children's fable about the turtle and hare tells the story of an improbable race between these 2 animals. The highly favored, speedy, overconfident hare rushes ahead but then becomes distracted and pauses before finishing the race. The turtle plods along, slow and steady, passes the hare, and wins the race, proving that faster is not always better. In this issue of Pediatrics, Orr et al1 offer convincing evidence to dispute the premise that speed is what matters on transport. Their study offers support for what many pediatric practitioners have always suspected: taking pediatric intensive care to the child is better than rushing the child to the PICU. Their findings build on an earlier study that demonstrated improved survival in septic shock when appropriate therapy was initiated before PICU arrival.2 A more important determinant of survival is probably the initiation of appropriate care, not a specific location.

Both specialized and general transport teams participate in the transport of children. Specialization typically refers to transport teams with extensive pediatric training that are primarily dedicated to the transport of neonates and children. General teams transport patients of all ages, with children usually constituting a much smaller proportion of their total transport volume. With their well-designed prospective, cohort study of transport team composition and experience with patient outcomes, Orr et al provide the strongest evidence yet that using a specialized . . . [Full Text of this Article]

Address correspondence to Mona L. McPherson, MD, MPH, Texas Children's Hospital, 6621 Fannin St, WT 6-006, Houston, TX 77030. E-mail: mlmcpher@texaschildrens.org


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