ABSTRACT 867

Abstract

Background and aims: UK PICS state that a PICU retrieval team should arrive within 3 hours of acceptance (or 4 hours if remote). This target was based solely on consensus and does not incorporate other clinical variables. During peak times, retrieval services are forced to triage patients to best utilise resources. Aims: Children's Acute Transport Service (CATS) is a UK PICU retrieval team. We examined: Time our patients remain in a District General Hospital (DGH) awaiting retrieval. Frequency of critical incidents (as per PICANET guidelines) that occur in patients. Any association between critical incidents and variables such as patient age; gender; out of hours referral (OOH); illness severity; time for team arrival. Methods: Consecutive patients retrieved 1/09/2012 to 28/2/2013 recruited. Demographic and clinical data recorded at referral and during retrieval. PIMa score calculated using PIM2 variables at acceptance, as a surrogate marker of illness. Classic PIM2 recorded at time of arrival of CATS. The need for informed consent waived by local audit department. Results: 549 patients recruited. The median (IQR) acceptance to arrival time 113 mins (72, 196). 107 (19.5%) of patients waited > 4 hours . 83 and 94 patients had ³1 incident reported at DGH and CATS respectively. DGH incidents occurred in patients relatively younger and sicker at referral (Table 1). When age, OOH, time from acceptance to retrieval and PIMa were examined using logistical regression analysis, the only independent predictor of a DGH incident was PIMa (p=0.019).Table: No title available.Conclusions: The ability to triage for disease severity at referral appears the most important factor for patient safety.