Article Text
Abstract
Aims: To compare the proportion of airway and vascular access procedures performed by referring hospital staff on critically ill children in two discrete time periods, before and after widespread use of a specialised paediatric retrieval service.
Methods: Transport data were obtained from retrieval logs of all children for whom a paediatric retrieval team was launched in each of two time periods (October 1993 to September 1994; and October 2000 to September 2001).
Results: The overall intubation rate was similar in the first and second time periods (83.9% v 79.1%). However, 31/51 (61%) retrieved children were intubated by referring hospital staff in 1993–94, compared to 227/269 (84%) in 2000–01. Referring hospital staff gained central venous access in 11% v 18% and arterial access in 22% v 19% of retrieved children in the first and second time periods respectively. This was in spite of a significant reduction in the proportion of children on whom these procedures were performed.
Conclusion: Referring hospital staff are performing a greater proportion of initial airway and vascular access procedures undertaken in the stabilisation of sick children retrieved by a specialised paediatric retrieval team. The provision of this service has not resulted in the loss of vital skills at the local hospital.
- paediatric intensive care
- paediatric interhospital transport
- paediatric retrieval service
- referring hospital
- stabilisation skills
- DGH, district general hospital
- PIC, paediatric intensive care
- PICU, paediatric intensive care unit
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Footnotes
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Contributorship: PR and DT conceived the study idea; PR designed the study, analysed the data, and wrote the first and second drafts of the paper; AT collected the data and helped in data analysis; JB collected data and supervised the first draft; SA and PH collected the data, helped in data analysis, and supervised the second draft. PH will serve as guarantor to the paper.