Q&A For Pediatric Patient Transport

Posted on August 21, 2018

Pediatric patient transport warrants an ambulance with paramedic care. It is for children who may be critically ill or injured and require specialized care or who are travelling long distances.:
 

What to look for in a pediatric patient transport company?

A pediatric patient transport company should be able to deliver advanced pediatric critical care to the the pediatric patient’s bedside at the referring facility and capable of maintaining the same level of care during air or ground transport to the receiving facility.
 

What if our agency does not have a child specialist EMS team?

It is always best to opt for EMS agencies that specialize in pediatric transport to transport a pediatric PUI. Even where pediatric patient transport is not available, all EMS units ought to be medically equipped to meet basic and advanced life support needs of children.
 

Can a caretaker accompany a child?

It is normal for a caretaker to be with the pediatric patient during transport. However, if there are concerns for disease containment, certain precautions need to be taken. Firstly, in circumstances where the pediatric patient exhibits only mild symptoms like fever and vomiting, it is permissible for the caretaker to be there but they should wear a face shield or mask, gloves and impermeable gown. Assistance is required for donning and doffing of the PPE. Where there is a risk of being exposed to the body fluids of the child, the caretaker is not permitted to accompany the pediatric patient.
 

What steps should be taken to expedite the process?

To expedite the transfer, the forms should be completed before the pediatric patient transport team arrives. Copies of medical history of the pediatric patient, along with any scanned copies of radiologic studies carried out, such as X-rays and magnetic resonance imaging (MRI) should be compiled together for the pediatric patient transport team.
 

How will be the pediatric patient transported?

The best transport method will be determined depending on the pediatric patient’s condition and the distance to be covered. The transport team would include a pediatrician or neonatal nurse practitioner, a nurse and emergency medical technicians (EMTs). The possible options are:

  • Ground ambulance service, equipped with specialized pediatric technology.
  • Pediatric patient air transport could be carried out using fixed wing airplane with a medical team for distances greater than 100 miles or a helicopter.

How to prepare for the journey?

It is advisable for the family and the pediatric patient not to leave the premises of the facility before the pediatric patient transport team arrives, as family consent before departure is important.

Only upon arrival would the team be able to determine if a caretaker can accompany the pediatric patient. Hence, this is dependable on the patient's condition.

Parents are also advised not to follow the ambulance, in order to avoid creating a hazardous situation.
 

Should PPE be worn by children for transport?

No, children should not wear PPE. PPE has been designed to restrict the wearers contact with other people’s body fluids and not to contain the body fluids of the person wearing it. Infact, covering the child with any protective equipment can interfere with the treatment, so it is not advisable to put anything that may restrict access to the pediatric patient.
 

What about vehicle and equipment decontamination?

Where an isopod is not available, the EMS agency should have a plan to decontaminate the vehicle and equipment after transport of a child suspected to have Ebola. If the agency does not have an internal decontamination team, they should collaborate with other agencies or with the hospital for execution.
 

What are the key considerations for safe transport of children?

Department of Transportation’s (DOT) has a set guidelines for safe ground ambulance, these could be accessed here. It is best to use a patient’s own car seat and decontaminate it later, in accordance with CDC’s Waste Management Guidelines. Where an EMS agency’s car seat or Pedi-Mate is used, this too should be decontaminated accorded to the guidelines set forth by the body.
 

Are isopods available for the transport of children?

An Isopod (pediatric isolation transport unit) is a piece of equipment that allows full air circulation or negative pressure, for up to three persons. Companies such as Airmed that provide pediatric patient air transport usually have isopods on-board.