- Outcomes for critically ill and injured children improve when treatment is provided by skilled pediatric specialist transport teams.
- Appropriate medical care for any patient with an emergent condition should never be delayed because of inability to find a caregiver or guardian to give consent for treatment.
- The referring physician is responsible for stabilizing the patient's condition, within the capabilities of the referring institution, before the patient is transferred t another institution.
- Limitation of resuscitation orders (DNR) may be revoked at any time according to the parents or legal guardians' wishes.
- Composition of team personnel is driven by the needs of the patient being transported.
- A well-run communication system is vital for the safety of patients and transport personnel.
- All communications pertaining to transport should be recorded and saved.
- Transport personnel must be familiar with their protocols and the limitations and responsibilities of their specific profession's scope of practice.
- Safety training for the teams should be part of their initial training and ongoing competencies.
- Personal protective equipment is important to protect team members.
- Stresses of flight affect both the patient and crew members and should always be taken into consideration when transporting a patient.
- At high altitude, a child may become hypoxic and pneumothoraxes can expand.
Specialized transport systems have evolved from military conflicts; the earliest references date from the Napoleonic wars. The first reported transport of a patient via aircraft took place in 1915. Invented in 1942, the helicopter saw its first use in air medical transport in Burma in 1944.1 Development of specialized pediatric transport teams began in the 1970s with the establishment of neonatal intensive care units. Outcomes for critically ill and injured children improve when treatment is provided by skilled pediatric specialists. The need for rapid and safe transport of such children has driven the formation of specialized pediatric transport teams.
Approximately 2%–3% of all children seeking treatment in an emergency department (ED) are not accompanied by a parent or legal guardian. All efforts should be made to obtain consent for treatment and transfer of a pediatric patient, but appropriate medical care for the patient with an urgent or emergent condition, including transport, should never be withheld or delayed because of problems obtaining consent. Appropriate documentation of these efforts is important.
Federal law under the Emergency Medical Treatment and Active Labor Act (EMTALA) mandates a medical screening for every patient seeking treatment in an ED of any hospital that participates in programs that seek federal funding, regardless of reimbursement considerations. If an emergency medical condition is identified, EMTALA mandates therapy up to and including surgical intervention.2 If definitive care cannot be rendered at the local hospital, the patient should be transferred to a hospital that has the resources and capabilities to care for the patient. The referring physician is responsible for stabilizing the patient's condition, within the capabilities of the referring institution, before the patient is transferred to ...