ABSTRACT 784

Abstract

Background and aims: The use of specialized pediatric transport teams has been shown to reduce adverse events and lower mortality rates in children with medical illness. Rapid transport of trauma patients requiring surgical intervention to tertiary care centers is intuitive; however, the specialized care provided by pediatric transport teams may be beneficial in subsets of trauma patients. Aims: Improved care during transport may be more advantageous than rapid transport in pediatric trauma patients not requiring immediate surgical intervention. Methods: Data was collected on all pediatric trauma patients transported between January2007-December2011 to Arkansas Children’s Hospital (ACH). Demographic data, vital signs, mortality scores, required interventions, and injury-severity scores (ISS) were compared between patients transported by a specialized pediatric team at ACH and state EMS services. Results: Univariate analysis showed that trauma patients transported by a specialized team had shorter Length of Stay (LOS), shorter ED LOS, and a higher probability of survival. Multivariate analysis, adjusting for age and ISS, revealed a significantly different ED LOS with patients transported by EMS teams spending an average of 0.67 (95% CI 0.65–0.68) hours longer in the ED. Conclusions: Trauma patients transported by a specialized team spent significantly less time in the ED prior to admission [2.5h(3.2 ± 3.9) vs 2.3h(2.6 ± 2.2) P<0.001], Improved care during transport, resulting in enhanced resuscitation, may decrease time spent in the ED, thus expediting appropriate ongoing care and rationing ED resources. Future evaluations will determine if differences exist in subsets of trauma patients and if the number of interventions during transport differs among specialized pediatric teams versus EMS teams.