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Pediatric Specialty Transport

Lynne M Gordon, Rebecca H Johnson, Margaret A Au, Shelby L Langer, Karen H Albritton
PURPOSE: The objectives of this study were to determine whether pediatricians are more likely than other primary care physicians (PCPs) to refer newly diagnosed adolescent and young adult patients with cancer to pediatric oncological specialists, and to assess the physician and patient characteristics that affect patterns of referral. METHODS: A cross-sectional vignette survey was mailed to PCPs to examine hypothetical referral decisions as a function of physician characteristics and patient characteristics, including diagnosis, age, gender, race/ethnicity, family support, transportation, insurance, and patient preference for site of care...
February 2018: Journal of Adolescent Health: Official Publication of the Society for Adolescent Medicine
Avik Chatterjee, Marvin So, Spencer Dunleavy, Emily Oken
BACKGROUND: We assessed whether and how health care organizations serving homeless pediatric patients meet recommendations issued by the American Academy of Pediatrics (AAP). METHODS: We conducted a web-based survey of Health Care for the Homeless (HCH) Program grantees serving children. RESULTS: Of 169 grantees, 77 (46%) responded. All organizations reported connecting patients to specialty services. Nearly all reported screening for homelessness (90%), facilitating Medicaid enrollment (90%), connecting patients to benefits (94%), addressing underlying causes of homelessness (83%), assisting with transportation (83%), and knowing about the causes of homelessness (76%)...
2017: Journal of Health Care for the Poor and Underserved
Emily Krennerich, Curtis G Sitler, Manish Shah, Fong Lam, Jeanine Graf
OBJECTIVE: This review describes disposition of transported children and identifies contributing factors affecting optimal patient placement. The study describes timing and patient placement indicators in transport patients to identify areas of improvement, re-education, and training. METHODS: A retrospective chart review for transports via our pediatric specialty transport team from January 1, 2012, to December 31, 2014, was performed. Patients were identified by the transport quality assurance performance improvement database, hospital electronic medical records, and transport medical records...
November 2017: Air Medical Journal
Jennifer N Fishe, Kevin J Psoter, Bruce L Klein, Jennifer F Anders
OBJECTIVE: Emergency medical services (EMS) typically transports patients to the nearest emergency department (ED). After initial presentation, children who require specialized care must undergo secondary transport, exposing them to additional risks and delaying definitive treatment. EMS direct transport protocols exist for major trauma and certain adult medical conditions, however the same cannot be said for pediatric medical conditions or injuries that do not meet trauma center criteria ('minor trauma')...
January 2018: Prehospital Emergency Care
Maria F Canizares, Jairo J Rios Roque, Gabriel Ramos Zelaya, Michelle A James
Congenital anomalies are prevalent in Nicaragua, and disability is estimated to be 10% in the general population. We studied children with congenital upper limb differences, as they are vulnerable to disability. This case study documents a collaborative effort between American and Nicaraguan orthopedic surgeons to determine unmet health needs of children with congenital upper limb differences at Hospital Manuel de Jesus Rivera ("La Mascota" Hospital) in Nicaragua, with the goal of developing programs that successfully address these needs within the context of the priorities of the community...
2017: Frontiers in Public Health
Shetal C Patel, Stephen Murphy, Scott Penfil, Debra Romeo, James H Hertzog
OBJECTIVE: The aim of the study was to evaluate the impact of ground versus air transport and use of pediatric specialty versus generalist transport teams on outcomes of pediatric trauma victims requiring interfacility transport. METHODS: A retrospective review of our hospital's trauma registry database was performed. Children with traumatic injuries who were transported from a referring hospital by either our pediatric specialty transport team or an outside generalist transport team were included in the analysis...
May 1, 2017: Pediatric Emergency Care
Michael T Bartenfeld, Stephanie E Griese, Steven E Krug, Joanne Andreadis, Georgina Peacock
A timely and effective response to public health threats requires a broad-reaching infrastructure. Children's hospitals are focused on evaluating and managing some of the most vulnerable patients and thus have unique preparedness and response planning needs. A virtual forum was established specifically for children's hospitals during the 2014-15 Ebola outbreak, and it demonstrated the importance and utility of connecting these specialty hospitals to discuss their shared concerns. Developing a successful children's hospital response network could build the national infrastructure for addressing children's needs in preparedness and response and for enhancing preparedness and response to high-consequence pathogens...
January 2017: Health Security
Sarah E Velasquez, Enrique Chaves-Carballo, Eve-Lynn Nelson
BACKGROUND: Approximately 2.7 million individuals in the United States are affected by epilepsy. It is the fourth most common neurological disorder and affects people of all ages, races, and economic backgrounds. In many rural states, the few pediatric neurologists commonly practice in the metropolitan areas. The inadequate resources present challenges for families residing in rural areas or with limited transportation resources. One remedy for this situation is to deliver pediatric neurology services to rural areas through videoconferencing...
November 2016: Pediatric Neurology
Jessica F Magidson, Risa B Weisberg
This article is an introduction to the second issue of a two-part Special Series on integrating cognitive behavioral therapy (CBT) into medical settings. The first issue focused on integrating CBT into primary care, and this issue focuses on implementing CBT in other specialty medical settings, including cancer treatment, HIV care, and specialized pediatric medical clinics. Models for treatment delivery to improve ease of implementation are also discussed, including telehealth and home-delivered treatment. The six articles in this series provide examples of how to transport CBT techniques that are largely designed for implementation in outpatient mental health settings to specialized medical settings, and discuss unique considerations and recommendations for implementation...
November 2014: Cognitive and Behavioral Practice
Michael T Bigham
No abstract text is available yet for this article.
November 2016: Acta Paediatrica
Michael T Meyer, Theresa A Mikhailov, Evelyn M Kuhn, Maureen M Collins, Matthew C Scanlon
OBJECTIVE: The purpose of this study was to determine if pediatric specialty pediatric team (SPT) interfacility-transported children from community emergency departments to a pediatric intensive care unit (PICU) have improved 48-hour mortality. METHODS: This is a multicenter, historic cohort analysis of the VPS, LLC PICU clinical database (VPS, LLC, Los Angeles, CA) for all PICU directly admitted pediatric patients ≤ 18 years of age from January 1, 2007, to March 31, 2009...
March 2016: Air Medical Journal
Ian K White, Ecaterina Pestereva, Kashif A Shaikh, Daniel H Fulkerson
OBJECTIVE Children with skull fractures are often transferred to hospitals with pediatric neurosurgical capabilities. Historical data suggest that a small percentage of patients with an isolated skull fracture will clinically decline. However, recent papers have suggested that the risk of decline in certain patients is low. There are few data regarding the financial costs associated with transporting patients at low risk for requiring specialty care. In this study, the clinical outcomes and financial costs of transferring of a population of children with isolated skull fractures to a Level 1 pediatric trauma center over a 9-year period were analyzed...
May 2016: Journal of Neurosurgery. Pediatrics
Gregory Hansen, Jeff K Vallance
BACKGROUND: Ventilation monitoring practice for intubated pediatric patients with severe traumatic brain injury (TBI) during interfacility transport (IFT) has not been well documented. We describe the difference of practices in ventilation monitoring during IFT from the perspective of a level I pediatric trauma center with an enormous catchment area. METHODS: Patients admitted between July 2008 and September 2013 at Winnipeg Health Science Center, Canada, were examined in this retrospective chart review...
December 2015: International Journal of Emergency Medicine
Marc Eckstein, Shira A Schlesinger, Stephen Sanko
BACKGROUND: With the increasing development of regional specialty centers, emergency physicians are often confronted with patients needing definitive care unavailable at their hospital. Interfacility transports (IFTs) may be a useful option to ensure timely, definitive patient care. However, since traditional IFT can be a challenging and time-consuming process, some EMS agencies that have previously limited their service to 9-1-1 emergency responses are now performing emergency IFTs. OBJECTIVE: We sought to determine the frequency and nature of transfers provided by a local fire-based 9-1-1 EMS agency that recently began to provide limited IFT for time-critical emergencies...
2015: Prehospital Emergency Care
Amee M Bigelow, M David Gothard, Hamilton P Schwartz, Michael T Bigham
BACKGROUND: There are nearly 200,000 US infants/children transported annually for specialty care and there are no published best practices in transport intubation. OBJECTIVE: Respiratory interventions are a priority in pediatric and neonatal critical care transport (PNCCT). A recent Delphi study identified intubation performance as an important PNCCT quality metric, though data are insufficient. The objective of the study is to determine multi-center rates of first attempt intubation success in pediatric/neonatal transport and identify practice processes associated with higher performing centers...
July 2015: Prehospital Emergency Care
Crystal N Joyce, Rachel Libertin, Michael T Bigham
OBJECTIVE: Family-centered care (FCC) in medicine highlights mutually beneficial partnerships among providers, patients, and families. In the field of specialty pediatric critical care transport (SPCCT), FCC includes family presence during transport. We sought to describe family presence and family/staff perspectives of FCC in transport. METHODS: This institutional review board-approved study established family presence rates among 5 SPCCT teams. At the top-performing family presence team, parents of transported children were interviewed...
January 2015: Air Medical Journal
Makoto Ando, Yukihiro Takahashi, In-Sam Park, Hitonobu Tomoike
BACKGROUND: There is currently a well-established network for the allocation of donor organs for transplantation in Japan, and emergency patients are often transported by the "Doctor Helicopter". However, interhospital transfer of patients, which can require aircraft with specialized equipment, depends on arrangement by each responsible hospital. METHODS AND RESULTS: Since 2009 there were 41 interhospital aviation transfers of pediatric patients with intractable cardiac or airway diseases seeking surgical treatment at Sakakibara Heart Institute...
2015: Circulation Journal: Official Journal of the Japanese Circulation Society
Kristen A Smith, M David Gothard, Hamilton P Schwartz, John S Giuliano, Michael Forbes, Michael T Bigham
Abstract Objective. Nearly 200,000 pediatric and neonatal transports occur in the United States each year with some patients requiring tracheal intubation. First-pass intubation rates in both pediatric and adult transport literature are variable as are the factors that influence intubation success. This study sought to determine risk factors for failed tracheal intubation in neonatal and pediatric transport. Methods. A retrospective chart review was performed over a 2.5-year period. Data were collected from a hospital-based neonatal/pediatric critical care transport team that transports 2,500 patients annually, serving 12,000 square miles...
January 2015: Prehospital Emergency Care
Lara D Vogel, Hurnan Vongsachang, Elizabeth Pirrotta, James F Holmes, James M Holmes, John Sherck, Christopher Newton, Peter D'Souza, David A Spain, N Ewen Wang
BACKGROUND: Due to the scarcity of specialized resources for pediatric trauma, "regionalization," or a system designed to get "the right child, to the right place, at the right time," is vital to quality pediatric trauma care. In Northern California, four pediatric trauma centers serve 3.9 million children within a geographically diverse area of 113,630 square miles. A significant proportion of children with trauma is initially triaged to nontrauma hospitals and may require subsequent transfer to a specialty center...
September 2014: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
Orgul D Ozturk, Suzanne McDermott, Joshua R Mann, James W Hardin, Julie A Royer, Lijing Ouyang
BACKGROUND: For people with muscular dystrophy (MD) health care access is crucial and utilization is expected to be high. A multidisciplinary approach is needed for optimal management of symptoms of this rare condition. Regular primary care, specialty care, therapy, and medicine use can improve quality of care and reduce need for emergency treatment and hospitalization. We analyzed health insurance and administrative data to test for racial disparities in regular care use among teenagers and young adults with MD...
October 2014: Medical Care
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