A Longitudinal View of Resident Education in Pediatric Emergency Interhospital Transport

Giardino, Angelo P.; Tran, Xuan G.; King, Jason; Giardino, Eileen R.; Woodward, George A.; Durbin, Dennis R.

doi:10.1097/pec.0b013e3181ef0473

Cited by 10 publications

(6 citation statements)

References 15 publications

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“…Our study confirms findings from previous studies regarding variable exposure to transport medicine for pediatric residents [5–7]. This study shows that there is broad agreement that Transport Physiology, Principles of Medical Control and Medical Protocols are of higher priority than Vehicle Safety, State and Federal Regulations or Medicolegal Issues.…”

Section: Discussionsupporting

confidence: 91%

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Education of pediatric subspecialty fellows in transport medicine: a national survey

2017

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BackgroundThe transport of critically ill patients to children’s hospitals is essential to current practice. The AAP Section on Transport Medicine has raised concerns about future leadership in the field as trainees receive less exposure to transport medicine. This study identifies the priorities of pediatric subspecialty fellows, fellowship directors and nursing directors in transport medicine education.MethodsInternet based surveys were distributed to fellows, fellowship directors and nursing directors of transport teams affiliated with ACGME-approved fellowships in Neonatal-Perinatal Medicine (NPM), Pediatric Critical Care Medicine (PCCM), and Pediatric Emergency Medicine (PEM). Data collection occurred November 2013 to March 2014.ResultsFour hundred and sixty-six responses were collected (357 fellows, 82 directors, 27 nursing directors): Six curricular elements were ranked by respondents: Transport Physiology (TP), Medical Control (MC), Vehicle Safety (VS), Medicolegal Issues (ML), Medical Protocols (MP) and State and Federal Regulations (SFR). Fellows and fellowship directors were not significantly different: TP (p = 0.63), VS (p = 0.45), SFR (p = 0.58), ML (p = 0.07), MP (p = 0.98), and MC (p = 0.36). Comparison of subspecialties found significant differences: PEM considered TP less important than NPM and PCCM (p < 0.001, p < 0.001), VS less important than NPM (p = 0.001). PEM viewed SFR and MC more important than PCCM (p = 0.006, p = 0.002); ML more important than PCCM and NPM (p = 0.001, p < 0.001). PCCM ranked MC more important than NPM (p = 0.004). Nursing directors considered TP less important than NPM and PCCM (p < 0.001, p = 0.002).ConclusionsWhen ranking curricular elements in transport medicine, fellows and fellowship directors do not differ, but comparison of subspecialties notes significant differences. A fellow curriculum in transport medicine will utilize these results.Electronic supplementary materialThe online version of this article (doi:10.1186/s12887-017-0780-5) contains supplementary material, which is available to authorized users.

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Section: Discussionsupporting

confidence: 91%

“…Previous studies demonstrate participation in Emergency Medical Services or pediatric transport teams occurs in just 60% of pediatric residencies, with variable team roles and experiences at those programs [5–7]. It is clear that pediatric residents do not receive uniform exposure to transport medicine.…”

Section: Introductionmentioning

confidence: 99%

Education of pediatric subspecialty fellows in transport medicine: a national survey

2017

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“…The previous studies have shown that the educational structure of interhospital transport team has been the strong point for successful of transportation. [10][11][12][13] We suggest that the transport teams should be trained for core concepts in pediatric transport. The teams should be able to perform emergency procedure such as ET tube intubation, defibrillation, and cardiopulmonary resuscitation.…”

Section: Personnelmentioning

confidence: 99%

Assessment of interhospital transport care for pediatric patients

2020

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Background: Many critically ill patients require transfer to a higher-level hospital for complex medical care. Despite the publication of the American Academy of Pediatrics guidelines for pediatric interhospital transportation services and the establishment of many pediatric transport programs, adverse events during pediatric transport still occur.Purpose: To determine the incidence of adverse events occurring during pediatric transport and explore their complications and risk factors.Methods: This prospective observational study explored the adverse events that occurred during the interhospital transport of all pediatric patients referred to the pediatric intensive care unit of Ramathibodi Hospital between March 2016 and June 2017.Results: There were 122 pediatric transports to the unit. Adverse events occurred in 25 cases (22%). Physiologic deterioration occurred in 15 patients (60%). Most issues (11 events) involved circulatory problems causing patient hypotension and poor tissue perfusion requiring fluid resuscitation or inotropic administration on arrival at the unit. Respiratory complications were the second most common cause (4 events). Equipmentrelated adverse events occurred in 5 patients (20%). The common causes were accidental extubation and endotracheal tube displacement. Five patients had both physiologic deterioration and equipment-related adverse events. Regarding transport personnel, the group without complications more often had a physician escort than the group with complications (92% vs. 76%; relative risk, 2.4; <i>P</i>=0.028).Conclusion: The incidence of adverse events occurring during the transport of critically ill pediatric patients was 22%. Most events involved physiological deterioration. Escort personnel maybe the key to preventing and appropriately monitoring complications occurring during transport.

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“…17,[19][20][21] Multiple modalities are used in continuing education programs, including quality improvement initiatives, didactics, skills laboratories, case conferences, case simulations, literature/practice reviews, computer-based activities, and peer performance. Coupling continuing education with competency assessments allows programs to provide individual support while maintaining overall performance standards.…”

Section: Training Simulation Safety and Work Hours Trainingmentioning

confidence: 99%

Pediatric and Neonatal Interfacility Transport: Results From a National Consensus Conference

et al. 2013

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The practice of pediatric/neonatal interfacility transport continues to expand. Transport teams have evolved into mobile ICUs capable of delivering state-of-the-art critical care during pediatric and neonatal transport. The most recent document regarding the practice of pediatric/neonatal transport is more than a decade old. The following article details changes in the practice of interfacility transport over the past decade and expresses the consensus views of leaders in the field of transport medicine, including the American Academy of Pediatrics’ Section on Transport Medicine.

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A Longitudinal View of Resident Education in Pediatric Emergency Interhospital Transport

Cited by 10 publications

References 15 publications

Education of pediatric subspecialty fellows in transport medicine: a national survey

Education of pediatric subspecialty fellows in transport medicine: a national survey

Assessment of interhospital transport care for pediatric patients

Pediatric and Neonatal Interfacility Transport: Results From a National Consensus Conference

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