• Corina Noje, Melania M Bembea, Kristen L Nelson McMillan, Marissa A Brunetti, Meghan L Bernier, Philomena M Costabile, Bruce L Klein, Jordan Duval-Arnould, Elizabeth A Hunt, and Donald H Shaffner.
• Department of Anesthesiology and Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, MD.
• Pediatr Crit Care Me. 2019 Jan 1; 20 (1): e30-e36.

ObjectivesTo describe the U.S. experience with interhospital transport of children in cardiac arrest undergoing cardiopulmonary resuscitation.DesignSelf-administered electronic survey.SettingPediatric transport teams listed with the American Academy of Pediatrics Section on Transport Medicine.SubjectsLeaders of U.S. pediatric transport teams.InterventionsNone.Measurements And Main ResultsSixty of the 88 teams surveyed (68%) responded. Nineteen teams (32%) from 13 states transport children undergoing cardiopulmonary resuscitation between hospitals. The most common reasons for transfer of children in cardiac arrest are higher level-of-care (70%), extracorporeal life support (60%), and advanced trauma resuscitation (35%). Eligibility is typically decided on a case-by-case basis (85%) and sometimes involves a short interhospital distance (35%), or prompt institution of high-quality cardiopulmonary resuscitation (20%). Of the 19 teams that transport with ongoing cardiopulmonary resuscitation, 42% report no special staff safety features, 42% have guidelines or protocols, 37% train staff on resuscitation during transport, 11% brace with another provider, and 5% use mechanical cardiopulmonary resuscitation devices for patients less than 18 years. In the past 5 years, 18 teams report having done such cardiopulmonary resuscitation transports: 22% did greater than five transports, 44% did two to five transports, 6% did one transport, and the remaining 28% did not recall the number of transports. Seventy-eight percent recall having transported by ambulance, 44% by helicopter, and 22% by fixed-wing. Although patient outcomes were varied, eight teams (44%) reported survivors to ICU and/or hospital discharge.ConclusionsA minority of U.S. teams perform interhospital transport of children in cardiac arrest undergoing cardiopulmonary resuscitation. Eligibility criteria, transport logistics, and patient outcomes are heterogeneous. Importantly, there is a paucity of established safety protocols for the staff performing cardiopulmonary resuscitation in transport.

23 keywords...

hide…