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backgrounds offers the potential for those members to assist in and complement
the training and care delivery processes. Regardless of the medical background of
the transport participants, pretransport education and experience in the mobile
environment is imperative.
Transport team capabilities and types of personnel vary significantly,
depending on the transport system. Pediatric CCT teams, often the optimal
interfacility transport configuration for children, usually have several specific
types of providers. At the center of most pediatric CCT teams are highly trained
pediatric CCT nurses. These nurses usually have significant critical care and/or
emergency medicine experience before becoming members of the transport
service. Their technical and cognitive skills are enhanced by additional formal
and informal specialized training and experience. Such training may allow them
to be classified or credentialed as practitioners with advanced skill certification in
certain jurisdictions. Depending on the sophistication of the transport system,
training opportunities, skills, and medical licensure issues, transport nurses often
provide advanced management for these children. This includes diagnostic and
assessment skills, as well as procedural interventions (e.g., advanced airway
management, central venous access, thoracentesis, etc.). In addition to their
cognitive and technical skills, transport nurses must serve as experts in the
environment in which they practice. The transport nurse should be intimately
aware of all operating systems within the transport environment, as well as safety
procedures for the patient and the transport team. The medical skills of pediatric
transport nurses can often be complemented by the addition of a physician
(attending, fellow, or senior resident with prior critical care exposure and
experience), advanced practice providers (NP, PA), respiratory therapist,
paramedic, or another nurse.
The most common model for neonatal transport teams is one registered nurse
and one respiratory therapist. Karlsen et al. found 26 different team
configurations in a survey of 335 neonatal transport programs. The second most
common model is two nurses. Most experts recommend at least two clinical
members on each team, but some one-person teams exist. Other teams routinely

utilize three members. Team compositions vary greatly in different systems, and
no single team configuration is optimal for all situations. The ideal team
composition is one that can address the acute and projected needs of the patient,
but also has the flexibility to quickly be revised when necessary.
There is also potential educational value (as compared with service use) of
resident trainees in the transport environment. Many pediatric programs include
residents and fellows as part of the patient care team; in other cases, they