Referrals and Transport ofcritically ill children

Dr P RamnarayanChildren’s Acute Transport Service & St Mary’s Hospital, London

Chair, Critical Care Transport Section, ESPNIC

Paediatric critical care - facts

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Critical illness/injury is rare

Critical care is highly specialised

Volume-outcome relationship

Sources of PIC admission

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PICUPICU

Plannedadmissions

Unplannedadmissions

(samehospital) Unplanned

admissions

(otherhospital)

Intensive care transport

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RequiresIntensiveCare

IntensiveCareUnit INTENSIVE CARE TRANSPORT TEAM

Intensive Care

Specialist transport teams

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An integrated and safe system

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Equipmentsafe

compatible

Networks

teamworkoutreach

Structure

protocolsprocesses

Staffexperiencedsupported

Certified portable equipment

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Networked model

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Triage Advice

Bed finding Transport

TT

Remote consultation

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Team training

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Simulation based trainingPractical workshopsCase reviews

Shared clinical guidelines

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“Data! Data!Data” he criedimpatiently. “I

can’t makebricks without

clay”

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Critical incidents

Outcome oftransport

Team composition

PICANet transport dataset

PIM2/3 score

Time intervals

Interventions

PICANet transport dataset

GAMUT initiative

• Aggregate data submitted to online database• Covers adult, newborn and paediatric transport• 15 quality metrics in report

DEPICT study

Association between timeliness of arrival of PIC transport team atbedside and clinical outcome

Association between care delivered by the PIC transport team andclinical outcome

Experiences and perspectives of parents/families/children transported toPICU and clinicians

Health economic evaluation

Mathematical modelling

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European collaboration