Application and exploration of critical illness children interhospital transportation system

Abstract

Objective To investigate the value of the interhospital transportation and the advantage of the cooperative network to the critically ill children. Methods The clinical data of 232 critically ill children transported from other hospitals in long distances to PICU of Fudan University Affiliated Children Hospital cooperated with Shanghai 120 interprovincial transport Department, between Oct 2010 and Oct 2013, were analyzed retrospectively. Results A total of 232 critically ill children were transported from 31 hospitals of Eastern China region including five provinces and the city of Shanghai.Among these critically ill children 141 cases were male and 91 cases were female, with age from 29 days to 13 years(median age was 12 months) and weight from 2.5 to 66 kg(median weight was 10 kg). The average pediatric clinical illness score was 80.4±7.7, 155 cases(66.8%) were single organ dysfunction, 55 cases(23.7%) were multiple organs dysfunction, 105 cases(45.3%) were mechanical ventilation required for transportation.Referral radius was 50-1 000 km(median). Among these patients, 87 cases(37.3%) were transported over 200 km radius and 73 cases(36%) were transported 101-200 km, 62 cases(26.7%) were transported 100 km or less.During the transportation, 0 case died, 3 cases(1.3%) received cardiopulmonary resuscitation treatment, 2 cases(0.9%) received electrical conversion treatment, 2 cases(0.9%) were replaced endotracheal intubation, the success rate of transportation was 100%.The top 4 diseases were respiratory diseases(90 cases, 38.8%), neural diseases(43 cases, 18.5%), cardiovascular diseases(36 cases, 15.5%) and acute pediatric trauma(28 cases, 12.1%). All 232 critically ill children were admitted to our PICU for further treatment through the Green Channel.In the end, 178 cases(76.7%) discharged, 24 cases(10.3%) gave up and 32 cases(13.8%) died.Among these 232 critically ill children, 30 cases(12.9%) received special organ replacement treatment, 4 cases(1.7%) of whom were treated with extracorporeal membrane oxygenation, 26 cases(11.1%) received blood purification therapy. Conclusion Establishing the system of transportation between PICU of hospitals will be propitious to treat the critically ill children energetically and effectively.It is worth promoting to master the transportation indication of children with critical illness, which is safe and reliable. Key words: Critical ill; Inter-hospital transportation; Children