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Pediatric critically ill transport

Amanda Calhoun, Martin Keller, Junxin Shi, Celeste Brancato, Kathy Donovan, Diana Kraus, Julie C Leonard
INTRODUCTION: Studies show that pediatric trauma centers produce better outcomes and reduced mortality for injured children. Yet, most children do not have timely access to a pediatric trauma center and require stabilization locally with subsequent transfer. Investigators have demonstrated that pediatric transport teams (PTT) improve outcomes for critically ill children; however, these studies did not differentiate outcomes for injured children. It may be that moderate to severely injured children actually fare worse with PTT due to slower transport times inherent to their remote locations and thus delays in important interventions...
September 16, 2016: Prehospital Emergency Care
Guillaume Mortamet, Manoelle Kossorotoff, Amandine Baptiste, Nathalie Boddaert, Martin Castelle, Philippe Hubert, Fabrice Lesage, Sylvain Renolleau, Mehdi Oualha
BACKGROUND: The authors aimed to collect all brain magnetic resonance imaging (MRI) performed in critically ill children in the authors' medical pediatric intensive care unit over a 2-year period (2012-2013) to (1) describe the findings and (2) assess its contribution on practical patient care. METHODS: This is a single-center and retrospective study. All children without traumatic brain injury who underwent a brain MRI during pediatric intensive care unit stays were included...
September 2, 2016: Journal of Child Neurology
Cynthia Foronda, Brigit VanGraafeiland, Robert Quon, Patricia Davidson
BACKGROUND: The handover and transport of critically ill pediatric patients requires communication amongst multiple disciplines. Poor communication is a leading cause of sentinel events and human factors affect handover and transport. OBJECTIVES: To synthesize published data on pediatric handover and transport and identify gaps to provide direction for future investigation. METHODS: Integrative literature review. RESULTS: Forty research studies were reviewed and revealed the following themes: risk for patient complications, standardized communication, and specialized teams and teamwork were associated with improved outcomes...
October 2016: International Journal of Nursing Studies
Michael T Bigham
No abstract text is available yet for this article.
November 2016: Acta Paediatrica
Robert Wilkinson, Robert P Olympia, Jennifer Dunnick, Jodi Brady
OBJECTIVES: To describe the compliance of urgent care centers in the United States with pediatric care recommendations for emergency preparedness as set forth by the American Academy of Pediatrics. METHODS: An electronic questionnaire was distributed to urgent care center administrators as identified by the American Academy of Urgent Care Medicine directory. RESULTS: A total of 122 questionnaires of the 872 distributed were available for analysis (14% usable response rate)...
February 2016: Pediatric Emergency Care
(no author information available yet)
No abstract text is available yet for this article.
August 2015: Zhonghua Er Ke za Zhi. Chinese Journal of Pediatrics
Katie Moynihan, Brent McSharry, Peter Reed, David Buckley
OBJECTIVES: Centralization of PICUs requires a transport system that delivers patient outcomes equivalent to that of the same institution admissions. Our aim was to evaluate how pediatric critical care retrieval, distance traveled, and referral center level of ICU support impact on outcomes in unplanned admissions. DESIGN: Retrospective cohort study. SETTING: The national PICU in New Zealand. PATIENTS: A total of 5,609 (45% retrieved) unplanned pediatric admissions (< 15 yr) between January 1, 2004, and January 1, 2014...
February 2016: Pediatric Critical Care Medicine
Julia Fuzak Freeman, Christopher Ciarallo, Lara Rappaport, Maria Mandt, Lalit Bajaj
OBJECTIVES: Prehospital pediatric airway management is difficult and controversial. Options include bag-mask ventilation (BMV), endotracheal tube (ETT), and laryngeal mask airway (LMA). Emergency Medical Services personnel report difficulty assessing adequacy of BMV during transport. Capnography, and capnograph tracings in particular, provide a measure of real-time ventilation currently used in prehospital medicine but have not been well studied in pediatric patients or with BMV. Our objective was to compare pediatric capnographs created with 3 airway modalities...
January 2016: American Journal of Emergency Medicine
Maria Hernandez, Nayla Hojman, Candace Sadorra, Madan Dharmar, Thomas S Nesbitt, Rebecca Litman, James P Marcin
BACKGROUND: Rural and community emergency departments (EDs) often receive and treat critically ill children despite limited access to pediatric expertise. Increasingly, pediatric critical care programs at children's hospitals are using telemedicine to provide consultations to these EDs with the goal of increasing the quality of care. MATERIALS AND METHODS: We conducted a retrospective review of a pediatric critical care telemedicine program at a single university children's hospital...
January 2016: Telemedicine Journal and E-health: the Official Journal of the American Telemedicine Association
Xiulan Lu, Jun Qiu, Yimin Zhu, Peng Chen, Xiao Liu, Pingping Liu, Chao Zuo, Liang Tang, Zhenghui Xiao
OBJECTIVE: To assess the performance of pediatric risk of mortality (PRISM), pediatric index of mortality 2 (PIM2) in predicting mortality in critically ill pediatric patients via a prospective study. METHOD: The outcome and the variables required to calculate PRISM and PIM2 were collected. The efficiency of PRISM and PIM2 in differentiation between death and survival by calculating the area under the receiver operating characteristic curve (ROC). Calibration across deciles of risk was evaluated using the Hosmer-Lemeshow goodness-of-fit χ(2) test...
May 2015: Zhonghua Er Ke za Zhi. Chinese Journal of Pediatrics
Harriett Nelson, Sandra Mott, Monica E Kleinman, Richard D Goldstein
CONTEXT: Pediatric palliative transports, the practice of transporting critically ill children home for end-of-life care including extubation, are an option for children requiring high levels of medical support at end of life. Little is known about the experience from the perspective of the children and families. OBJECTIVES: To understand parents' perspectives on the experience of pediatric palliative transports. METHODS: Open-ended interviews were conducted using a qualitative descriptive design...
September 2015: Journal of Pain and Symptom Management
Michael H Stroud, Ronald C Sanders, M Michele Moss, Janice E Sullivan, Parthak Prodhan, Maria Melguizo-Castro, Todd Nick
OBJECTIVES: This article reports results of the first National Institutes of Health-funded prospective interfacility transport study to determine the effect of goal-directed therapy administered by a specialized pediatric team to critically ill children with the systemic inflammatory response syndrome. We hypothesized that goal-directed therapy during interfacility transport would decrease hospital length of stay, prevent multiple organ dysfunction, and reduce subsequent ICU interventions...
August 2015: Critical Care Medicine
Jun Qiu, Xiao-Li Wu, Zheng-Hui Xiao, Xian Hu, Xue-Li Quan, Yi-Min Zhu
BACKGROUND: With the unequal distribution of medical resources in developing countries, critically ill children need to be transferred to tertiary hospitals from primary hospitals with limited resources. Although a large number of critically ill children are transferred each day in China, the standard process of inter-hospital transport is not formulated. METHODS: We retrospectively analyzed the data collected during transport. A total number of 9231 patients (≤14 years) who had been transferred to the Hunan Children's Hospital by a specialized team from primary hospitals from January 1, 2009 to June 30, 2012 were included in the study...
February 2015: World Journal of Pediatrics: WJP
Marie Jesie Carrillo B
No abstract text is available yet for this article.
April 2014: Revista Chilena de Pediatría
Patrick C Drayna, Lorin R Browne, Clare E Guse, David C Brousseau, E Brooke Lerner
OBJECTIVE: Pediatric transports comprise approximately 10% of emergency medical services (EMS) requests for aid, but little is known about the clinical characteristics of pediatric EMS patients and the interventions they receive. Our objective was to describe the pediatric prehospital patient cohort in a large metropolitan EMS system. METHODS: This retrospective analysis of all pediatric (age <19 years) EMS patients transported from October 2011 to September 2013 was conducted by reviewing a system-wide National EMS Information System (NEMSIS)-compliant database of all EMS patient encounters...
July 2015: Prehospital Emergency Care
Don Hayes, Thomas J Preston, Mark Galantowicz, Joseph D Tobias, Corinne R Long, Gil Peri
INTRODUCTION: There are a limited number of pediatric lung transplant programs in the United States; therefore, geographical barriers limit critically ill children who may be good candidates for lung transplantation. MATERIALS AND METHODS: With advancements in technology, extracorporeal membrane oxygenation (ECMO) is becoming an option to bridge children requiring advanced life support to lung transplantation and offers the opportunity to transport critically ill children to pediatric lung transplant centers...
January 2015: Air Medical Journal
Janis M Quinn, Mary Clyde Pierce, Mark Adler
OBJECTIVE: Transport professionals must routinely engage in complex decision making. One challenging decision is the determination of mode of transport. This study explores the decisional factors involved in the determination of mobilizing ground ambulance versus helicopter for pediatric-neonatal interfacility transport. The aim was to gather initial qualitative data to aid in the development of an objective scoring tool that would be used to guide the mode of transport decision for pediatric and neonatal interfacility transport...
January 2015: Air Medical Journal
Nigel R Armfield, Mark G Coulthard, Anthony Slater, Julie McEniery, Mark Elcock, Robert S Ware, Paul A Scuffham, Mark E Bensink, Anthony C Smith
BACKGROUND: In many health systems, specialist services for critically ill children are typically regionalised or centralised. Studies have shown that high-risk paediatric patients have improved survival when managed in specialist centres and that volume of cases is a predictor of care quality. In acute cases where distance and time impede access to specialist care, clinical advice may be provided remotely by telephone. Emergency retrieval services, attended by medical and nursing staff may be used to transport patients to specialist centres...
2014: BMC Health Services Research
Sarah L Andrews, Stuart Lewena, Felix Oberender, Franz E Babl, Adam West, Sandy M Hopper
OBJECTIVE: The Victorian Paediatric Emergency Transport Service (PETS) transports critically unwell children to tertiary paediatric hospitals. Children not directly admitted to ICU go to a tertiary ED. These patients might require prolonged and high-level care. In light of the National Emergency Access Target, we describe this cohort, clinical care needs and process measures. METHODS: A retrospective chart review of patients retrieved by PETS to the Royal Children's Hospital (Melbourne, Australia) ED in 2012...
December 2014: Emergency Medicine Australasia: EMA
Thomas Blakeman, Tyler Britton, Dario Rodriquez, Richard Branson
BACKGROUND: Aeromedical transport of critically ill patients requires continued, accurate performance of equipment at altitude. Changes in barometric pressure can affect the performance of mechanical ventilators calibrated for operation at sea level. Deploying ventilators that can maintain a consistent tidal volume (VT) delivery at various altitudes is imperative for lung protection when transporting wounded war fighters to each echelon of care. METHODS: Three ventilators (Impact 731, Hamilton T1, and CareFusion Revel) were tested at pediatric (50 and 100 mL) and adult (250-750 mL) tidal VTs at 0 and 20 cm H₂O positive end expiratory pressure and at inspired oxygen of 0...
September 2014: Journal of Trauma and Acute Care Surgery
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