Name of the Procedure:

Supervision by a control physician of interfacility transport care of the critically ill or critically injured pediatric patient, 24 months of age or younger

Summary

This procedure involves a control physician overseeing the transport of a critically ill or injured pediatric patient, 24 months of age or younger, between medical facilities. The supervision includes maintaining two-way communication with the transport team before and during the transport, as well as at the referring facility.

Purpose

This procedure ensures the safe and effective transfer of critically ill or injured young patients from one medical facility to another. The goal is to provide continuous medical oversight, ensuring that the child's medical needs are met throughout the transport process.

Indications

• Critically ill or injured pediatric patients requiring specialized care not available at the current facility.
• Infants and toddlers 24 months of age or younger needing immediate, advanced medical treatment.
• Patients with severe trauma, respiratory distress, or other critical conditions that necessitate professional medical oversight during transport.

Preparation

• Confirm the transport team and control physician have all necessary medical information about the patient.
• Ensure the transport vehicle is equipped with appropriate medical equipment.
• Verify two-way communication systems are functional.
• Ensure the patient is stabilized as much as possible before transport.

Procedure Description

1. The control physician receives a briefing about the patient's condition and medical needs.
2. Two-way communication is established between the control physician and the transport team.
3. The control physician provides medical guidance to the transport team before departure.
4. Continuous monitoring and medical supervision are maintained during the transport.
5. Communication continues at the referring facility to ensure a safe handover.
6. The control physician documents the transport and supervision details.

Duration

The duration varies depending on the distance between facilities and the patient's condition, generally ranging from a few hours to half a day.

Setting

The procedure is carried out in an ambulance, helicopter, or other medical transport vehicles, with coordination from both the sending and receiving medical facilities.

Personnel

• Control Physician
• Transport Team (may include paramedics, nurses, and specialized transport personnel)
• Medical staff at both the referring and receiving facilities

Risks and Complications

• Potential for the patient's condition to deteriorate during transport.
• Technical failures in communication or medical equipment.
• Delays due to weather or traffic conditions.
• Risk is mitigated by the presence of skilled medical personnel and appropriate equipment.

Benefits

• Ensures continuous medical oversight during transport.
• Increases the likelihood of stable patient transfer and better outcomes.
• Provides access to specialized medical care that may not be available at the initial facility.

Recovery

• Ongoing medical care will continue at the receiving facility.
• The transport team and control physician will update the receiving facility on all pertinent information.
• The patient's recovery will depend on their underlying medical condition and the treatment provided at the new facility.

Alternatives

• In some cases, stabilization at the current facility may be pursued if transport is deemed too risky.
• Remote consultation with specialized physicians without transport.
• Pros and cons of alternatives include delayed access to specialized care versus risks associated with transport.

Patient Experience

• The young patient may not be fully aware of the transport due to age.
• Any discomfort is managed by the transport team, who are trained in pediatric care.
• Parents or guardians should be informed about the process and potential need for pain management or sedation.