Pediatric emergency medicine trisk 0296 0296

CHAPTER 11 ■ INTERFACILITY TRANSPORT
AND STABILIZATION
JESSICA J. WALL, GEORGE A. (TONY) WOODWARD, NICHOLAS TSAROUHAS

INTRODUCTION TO PEDIATRIC INTERFACILITY TRANSPORT
Infants, children, and adolescents are commonly evaluated and transported by
emergency medical services (EMS) systems worldwide. That discipline of
medicine is also termed prehospital care . Chapter 134 Prehospital Care addresses
prehospital stabilization and EMS systems. Although there is often an overlap in
personnel and services between prehospital and interfacility transport, this chapter
will focus primarily on interfacility transport medicine and transport stabilization.
While pediatric transport medicine has been a formally recognized entity for
approximately 25 years, it is still developing. A 2013 update, published by Stroud
et al., includes the discussion and results of multiple topics from a consensus
conference addressing pediatric and neonatal interfacility transport. Pediatric
interfacility transport involves patient transfer from one medical location to
another. This aspect of care delivery is vital, especially with the increased
regionalization and specialization of care systems, both in the United States and
internationally. Interfacility transport can originate from hospitals, emergency
care centers, physician offices, clinics, or other medical care facilities. There may
not always be a clear distinction in scope of practice between interfacility and
prehospital transport in terms of equipment, process, and in some instances,
personnel. Although transport providers care for patients with disease processes
and injuries similar to those seen in emergency departments and critical care
units, the environment and delivery of care differs ( Figs. 11.1 and 11.2 ).
Interfacility transport teams may also transport patients from the prehospital
environment, while EMS may be involved in interfacility transport. Differences
between prehospital and interfacility transport teams may include management
protocols, extrication issues, personnel types, staff education, and team
experience. Table 11.1 summarizes equipment common to both ground EMS and
transport ambulances.

Interfacility transport begins with the determination of the need or desire for
medical care at another institution. The most common reason for acute
interfacility transport is the need for advanced or specialized levels of care or
services that are not available at the referring facility. Examples include the need
for specialized capabilities (hyperbaric oxygen or extracorporeal membrane