Background and aims While specially trained paediatric transport teams are firmly in place in the developed nations for transporting the critically ill to the paediatric intensive care unit (PICU), the same is not true for the resource restricted ones. Although well known, this finding is underreported. The aim of our study was to evaluate the pre-hospital transport practices of those requiring PICU admission and their subsequent clinical course.
Methods We collected information on the pre-hospital transport factors of children requiring PICU admission at presentation to our paediatric emergency department (PED), over a period of 6 months (Jan–Jun 2013) and recorded their outcomes. The study was approved by the IEC.
Results A total of 319 patients presented to the PED during the study period. Fifty four children (17%) required PICU admission. Majority (60%) were males. Septic shock (48%) was the commonest admitting diagnosis. Only 2 patients referred were transported by ambulance (unaccompanied). Majority (35, 65%) reached the hospital by public transport systems such as auto rickshaw and bus. The median PIM2 probability was 56%. Of those admitted, 18% needed mechanical ventilation, and 46%, inotropic support within the first hour. Sixteen children (30%) died during PICU stay.
Conclusions There is an urgent need to develop and integrate paediatric retrieval teams into the health care system of our country. Special telemedicine facility or call centres could be set up for this purpose so that the information could reach these teams and the patient could be transferred in a timely and appropriate manner to the nearest PICU available.
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