The document discusses pediatric transport, including the goals of providing intensive care during transfer and improving outcomes through specialist care. It describes who may need transport, such as trauma victims, preterm infants with complications, and children with severe illnesses or complications. The transport team is described, including roles like medical director, transport coordinator, doctor, nurse, and paramedic. Considerations for transport include the patient's condition, transit times, vehicle availability, and weather. The primary assessment focuses on the pediatric assessment triangle of airway, breathing, and circulation. Secondary assessment includes signs and symptoms, history, and ongoing documentation to facilitate quality improvement.

1. Hawler medical university
College of medicine
Department of surgery /pediatric surgery

2. Goal of transport team :
 providing high-quality intensive care throughout the
transfer process.
 effectively providing an intensive-care bed on the
move .
 improve the morbidity and mortality through the
receipt of expert critical care and specialist expertise,
including surgery

3. Children who have
been the victims of
trauma
Term and preterm
neonates with either
major congenital
anomalies or
complications
Infants and older
children who have
either a severe form or a
complication
Who needs transport?

4. • The makeup of a regional transport team has many
influences, including local geographic factors such :
the distances needed to travel .
the size of the area covered.
presence of any difficult-to-access sites, such as islands or
remote mountainous sites .
Regional considerations

5. Transport team

6. Medical director Transport coordinator
Duty consultant

7. Transport doctor Transport nurse
Transport paramedic Transport driver/pilot

8. 4/14/2016
What Quality require of individuals to
perform critical-care transport ?
 Clinical skills, including manual dexterity
 Diagnostic skills
 Good interpersonal skills
 Ability to cope with stress
 Good physical health
 Resistance to fatigue and motion sickness
 Enthusiasm and commitment

9. What are Equipment's which need in
child transport??
Air way access Vascular access dressings
chest drains urinary catheters

10. Monitor Ventilator Defibrillator
Immobilization device Transportation device

11. transport vehicles

12.  Road ambulance
 advantage
Ease of training
Readily available
 Disadvantage
Traffic
Transport times longer

13.  Rotary-wing aircraft
 Advantage
Easy access to difficult
and remote location.
Smoother flight.
 Disadvantage
May require multiple patient transfers
In event of crash, less survivable

14.  Fixed-wing aircraft
4/14/2016
 Advantage
Rapid transport over distances
Fly above or around bad weather
 Disadvantage
Negative effects of high altitude if not pressurized
Substantially higher costs

15. Factors to be considered when selecting
mode of transport :
 Severity of patient’s illness
 Post-resuscitation stability
 Urgency for which specialist care is required
 Transit times between the hospitals involved
 Availability of vehicles
 Personnel’s abilities
 Weather and traffic conditions
 Geography
 Safety
 Cost

16. By : Pediatric assessment triangle(PAT): A-B-C

17. Primary assessment
Air way
Birthing
Circulation
Disability
Exposure

18.  patency
 Need simple management
 positioning
 head tilt-chin lift
 Use airway adjuncts ( oral
airway)
 Require advanced intervention
 ET intubation
 cricothyroidotomy
 CPAP
 Airway

19.  Respiratory rate
 Respiratory effort
 Airway and lung sounds
 Pulse oximetry
 Breathing

20.  Evaluate cardiovascular function
 heart rate and rhythm
 Pulses
 capillary refill time
 blood pressure and pulse pressure
 Evaluate end-organ function
 brain perfusion
 skin perfusion
 renal perfusion

21. Peripheral Pulses
• Present/Absent
• Strength
Skin Perfusion
 Capillary refill time
 Temperature
 Color
 Mottling

22.  Systemic perfusion
 CNS Perfusion
 Level of consciousness
 Renal Perfusion
 Urine 1-2 cc/kg/hr

23. Secondary assessment
 Signs and Symptoms
 Allergies
 Medications
 Past medical history
 Last meal
 Events leading to presentation

24. RECORD-KEEPING, CUMENTATION
AND AUDIT
 All parties involved in critical-care transport should
keep accurate notes of the referral, advice given and
management throughout the transport. This enables
accurate and meaningful audits to be performed and,
hence, facilitates ongoing quality improvement of the
service

25. SOCIAL ISSUES

26. OUTCOME
Specialist teams perform the majority of critical-care
transports safely and effectively.
• A clear understanding of individual roles and
responsibilities along with rapid and efficient
communication
• help to ensure that patients receive the most
appropriate care during transport before delivery of
definitive surgical care