• Valerie Astle, Meredith Louise Borland, Kim Betts, Simon Erickson, and Belinda Gowen.
• Emergency Department, Perth Children's Hospital, Perth, Western Australia, Australia.
• Emerg Med Australas. 2024 Jul 8.

ObjectiveThe aim of the present study was to assess the predictors of need for paediatric intensive care unit (PICU) admission for inter-hospital transfer patients to a tertiary paediatric hospital ED on high flow (HF) or continuous positive airway pressure (CPAP) ventilation.MethodsSingle-centre retrospective study of patients transferred to the state's tertiary paediatric hospital. Demographic information and disease management information was obtained.ResultsBetween October 2021 and September 2022, 53 patients were transferred to the tertiary hospital on HF or CPAP. Of these, 23 required admission to PICU. Those admitted to PICU had a higher median fraction of inspired oxygen than those not admitted (0.4 vs 0.3, respectively, P = 0.013). Patients transported by road (vs flight) were more likely (20/23 patients, RR = 3.15, P = 0.016) to be admitted to PICU (56% vs 18%). Those who had received CPAP prior to or during transfer were more likely to require PICU admission (P = 0.012).ConclusionWe have demonstrated that children who require CPAP to manage their respiratory disease are more likely to require PICU care on transfer to the tertiary paediatric hospital. In addition, those patients being transferred from secondary metropolitan hospitals after a trial of HF are also likely to require PICU care. This suggests that these patients should be directly admitted to PICU, allowing for improved patient experience and flow as well as reducing unnecessary ED resource utilisation.© 2024 Australasian College for Emergency Medicine.

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