Name of the Procedure:

Critical care face-to-face services during interfacility transport of critically ill or critically injured pediatric patient, 24 months of age or younger; each additional 30 minutes

Summary

This procedure involves the direct medical supervision and care provided to critically ill or injured infants and toddlers, aged 24 months or younger, during transport between healthcare facilities. The care is administered in segments of 30 minutes in addition to the primary care service provided.

Purpose

The purpose of this procedure is to ensure continuous, specialized medical attention for critically ill or injured pediatric patients during transport. The goals are to stabilize the patient's condition, manage any emergent situations during the transport, and ensure the patient arrives in the best possible condition to the receiving facility.

Indications

• Severe respiratory distress or failure
• Hemodynamic instability (unstable blood pressure or heart rate)
• Major trauma or injury requiring urgent care
• Severe infections or sepsis
• Critical medical conditions requiring urgent specialized care available only at another facility

Preparation

• The patient’s medical history and current condition will be reviewed.
• Necessary medical equipment and medications are prepared for transport.
• Parents or guardians might be provided guidelines on what to expect and how to prepare for the transport.

Procedure Description

1. Initial Assessment: The healthcare team assesses the patient’s immediate needs before transfer.
2. Stabilization: Any necessary interventions to stabilize the patient are performed (e.g., IV insertion, intubation, medication administration).
3. Transportation Setup: Specialized transport equipment, such as a ventilator or incubator, is prepared.
4. Continuous Monitoring: Vital signs, respiratory status, and hemodynamic status are continuously monitored by a critical care specialist during transport.
5. Interventions During Transport: Any necessary medical interventions are carried out as conditions change.
6. Handover: Upon arrival, the patient’s status and transported care details are communicated to the receiving medical team.

Duration

Each segment of this procedure lasts an additional 30 minutes, on top of the primary service duration.

Setting

This procedure is performed during patient transport between healthcare facilities, potentially involving ground or air ambulance services.

Personnel

• Pediatric Critical Care Physicians
• Critical Care Nurses
• Paramedics or Emergency Medical Technicians (EMTs)
• Transport Specialists

Risks and Complications

• Potential for patient deterioration during transport
• Medical equipment failure
• Delays due to logistical issues
• Infection risks due to invasive procedures

Benefits

• Continuous critical care during transport can improve patient survival and outcomes.
• Immediate medical response to any changes in the patient's condition.
• Stabilization of the patient prior to arrival at the receiving facility.

Recovery

• Post-transport, the patient will be continuously monitored at the receiving facility.
• Follow-up assessments and care plans will be organized based on the patient’s condition.

Alternatives

• Stabilization and treatment at the current facility if transport is not feasible.
• Utilization of telemedicine for consultation with specialists to avoid transport in less critical situations.

Patient Experience

• The patient may experience discomfort or distress due to the transport.
• Pain or discomfort is managed with appropriate medications and soothing techniques.
• Parents or guardians are usually not allowed in the transport vehicle, which may cause anxiety but will be communicated with throughout the process.