Transporting critically ill children

Increasing centralization of paediatric intensive care services and a reduction in the numbers of children cared for in adult intensive care units over the last 15–20 years has led to an increase in the numbers of critically ill children being transferred between clinical centres throughout the UK. Eighty percent of these retrievals are conducted by a specialist paediatric intensive care unit (PICU) team, 13% by a specialist non-PICU team, and only 7% by an ad-hoc, non-specialist team. Various pressures have made it increasingly difficult for PICUs to facilitate the timely retrieval of critically ill children whilst maintaining the quality of care being provided to patients already under their care. This situation has led to the development of regional, stand-alone transport teams throughout the UK over the last 5–10 years. A typical example of such a team is the North West & North Wales Paediatric Transport Service (NWTS). Utilizing the highly structured approaches advocated by the Paediatric and Neonatal Safe Transfer and Retrieval (PaNSTaR) and the Adult STaR courses; focussing on the SCRUMP (Shared assessment, Clinical isolation, Resource limitations, Unfamiliar equipment, Movement and Safety and Physiology) and the ACCEPT (Assessment, Control, Communication, Evaluation, Preparation/Packaging, Transportation) approach, regional transport teams have delivered significant measurable benefits in terms of patient outcomes and experiences when compared to previous models of service delivery.