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Clin Exp Pediatr > Accepted Articles
DOI: https://doi.org/10.3345/kjp.2019.00024    [Accepted]
Published online August 29, 2019.
Assessment of interhospital transport care in pediatric patients
Krittiya Chaichotjinda, Marut Chantra, Uthen Pandee 
Department of Pediatrics, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
Correspondence: 
Uthen Pandee, Tel: +6622012799, Fax: +6622011850, Email: uthenp@hotmail.com
Received: 3 January 2019   • Revised: 23 August 2019   • Accepted: 27 August 2019
Abstract
Background
Many critically ill patients need to be transferred to a higher-level hospital for more complex medical care. Although the American Academy of Pediatrics recommendation regarding pediatric transportation services has been published and many pediatric transport programs have been established, adverse events during pediatric transport still occur.
Purpose
To determine the incidence of adverse events occurring during pediatric transport and to explore the types of complication and risk factors.
Methods
A prospective observational study to explore the adverse events during interhospital transport of all pediatric patients referring to the pediatric intensive care unit was performed at the Ramathibodi Hospital from March 2016 to June 2017.
Results
There were total of 122 pediatric transports to the unit. Adverse events occurred in 25 cases (22%). Physiologic deterioration occurred in 15 patients (60%). Most of them (11 events) involved circulatory problems causing patient hypotension and poor tissue perfusion required fluid resuscitation or inotropic administration on arrival at the unit. Respiratory complications were the second most common causes (4 events). Equipment-related adverse events occurred in 5 patients (20%). The common causes were accidental extubation and endotracheal tube displacements. Five patients had both physiologic deterioration and equipment-related adverse events. Confine to the aspect of transport personnel, we found that in the group of non-complication had physician accompany more than the group with complication.(92% versus 76%, RR 2.4, p= 0.028).
Conclusion
We report an incidence of adverse events occurring during transport of critical ill pediatric patient of 22%. Most of the events were physiologic deterioration. The escort personal maybe the key person to prevent and appropriately monitor any complication during the transport.
Key Words: Interhospital transport, Pediatrics, Assessment




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