P0193 / #1923: COULD A DECISION TOOL BE USEFUL IN DETERMINING EARLY TRANSFER OF PATIENTS FROM PERIPHERAL HOSPITALS TO TERTIARY HDU/PICU?

Abstract

Aims & Objectives: To assess the feasibility of creating a decision tool for transfer of unwell children from peripheral hospitals to tertiary centre. Methods: CoMET is the dedicated Paediatric Critical Care Transport Service for East Midlands, United Kingdom – providing advice as well as stabilisation and transfer of unwell children to tertiary facilities. Data collected from CoMET’s web based data store over 2.5yrs. 14 physiological and treatment variables were recorded from the time of referral and scored for each patient, an overall score calculated based on these and their outcome destination recorded. Results: In <1 year olds, only 22 out of 266 patients had a full set of data. Of these, 14 patients scored ≥10 to ≤15 (MOD), four patients scored ≥7 to ≤9 (cardio-respiratory involvement) - these were all intubated and transferred to a PICU. Another four patients scored ≥1 to ≤6 - transferred to HDU. In 1-12 year olds, 13 out of 264 patients had full set of data. One died with cardiogenic shock and MOD - scored 18. Eight scored ≥10 to ≤17 (MOD), all intubated and transferred to PICU. Three scored ≥2 to ≤4, all transferred to HDU. Abb: MOD - multi organ dysfunction Conclusions: Despite small dataset, our study suggests higher scores are indicative of more severe derangement in physiological status likely needing more support and retrieval to a PICU. Hence there is scope for development of a scoring tool that might help in the decision making of dispatching the transport team in borderline cases: further studies are needed.