Transporting critically ill children

The centralization of specialized medical services has resulted in increasing numbers of children needing to be transferred between hospitals while critically ill. The majority of these transfers are now undertaken by expert teams that are trained and equipped to work in the mobile environment. Despite this, significant numbers of children are still transferred by ad hoc teams either because of clinical urgency or because the specialist teams are otherwise occupied or unavailable. Whether the transfer team is drawn from an intensive care unit, a general ward, an operating department or the emergency department, the majority of issues that cause problems are not fundamentally clinical. They arise from inadequate communication or are secondary to logistical problems during the transfer process. A smaller subgroup of issues arise because of a lack of familiarity with the adverse motion effects that the patient and equipment are exposed to in transit. We present a summary and discussion of the structured approach that has been developed, documented and taught in detail in the Paediatric and Neonatal Safe Transfer and Retrieval Course facilitated by the Advanced Life Support Group. This includes an overview of transfer organization and equipment considerations and limitations.