Pediatric Transport Destination

Hello everyone. In this video we'll be reviewing our pediatric transport destination protocol which will guide our decision making process when transporting pediatric patients which are considered less than 18 years old. Let's begin by discussing the different types of pediatric emergency departments. First is our basic pediatric emergency department or a bped. These patients have no pediatric admitting capabilities. They only treat minor pediatric illnesses and injuries. Now let's move to our advanced pediatric emergency department or the aped. These folks also have no pediatric admitting capabilities, but they provide advanced level pediatric care and resuscitation. Third is the comprehensive pediatric emergency department or the cped. This hospital has complete pediatric admitting capabilities and surgery options and is ideal for specific conditions like cardiac dysrhythmia arrest, severe respiratory distress, pediatric patients who have achieved ROSC sepsis alerts, cyanosis patients with persistent altered mental status that's not due to trauma status epilepticus and brief resolved unexplained events or bruit under the age of 12 months. So what is a brief resolved unexplained event? Essentially these are infants who are in the parents arms who suddenly stop breathing. They may turn blue, become cyanotic around the lips and they may lose their muscle tone. So now you essentially have a previously healthy baby who now turns limp, is not breathing and of course this will cause panic in the family. They'll call 911. However, because of the b the brief, these events resolve quickly and within, let's say 30 seconds the child, essentially their larynx or the vocal cords have been shut together, let's say because a little formula went down their airway, what have you, they will resolve and by the time we get there, these patients look perfectly fine. Don't fall into the trap of just saying mom and dad, everything's fine, no need to go to the hospital. All those patients, all brewy patients. Again, typically infants have to be transported to the hospital, a comprehensive pediatric emergency department, a CPED because they will require a workup. Usually they'll stay overnight for observation. That's what a brewery is. Not that complicated. And you'll know it when you see it because the parents will be freaked out and the child would look perfectly fine. Usually. Okay, now let's go over the transportation guidelines for the different patient priority levels. Priority one, two and three. Let's start with priority one patient. Those pediatric patients should go to a cped. Those are patients who have achieved ROSC patients who are pediatric respiratory arrest patients with successful airway management. Now remember, if a ground transport to a CPED is greater than 20 minutes, then you can transport to the closest APED. Now, priority one patients can be transported to the closest APED or CPED if they're pulseless. Pediatric patients. Pediatric respiratory arrest, patients with an unstable airway. What about the priority one patient who's in traumatic arrest? All those patients should be transported to the nearest emergency department if the trauma HAWK is unavailable and if ground transport is greater than 40 minutes. Okay, now let's talk about the priority two patient. Let's start with the trauma alert patient. These patients can be transported to the closest trauma center or the next closest if on bypass. Remember, we need a minimum of one paramedic and one EMT in the back of the rescue. On scene. Time should be shorter than 10 minutes. And document any reasons for delay in the EPCR narrative. If ground transport is greater than 25 minutes, transport by air. The next priority two patient is a stroke alert. Pediatric stroke alerts should be transported to St. Mary's Medical Center. Remember, if ground transport is greater than 40 minutes, transport by air. Next, sepsis alert. Also priority two. Transport these patients to the closest CPED. But if ground transport to the CPED is greater than 40 minutes, transport to the closest APED. St. Mary's hyperbaric chamber is also priority two. Be sure to ENCODE prior to transport to confirm availability. Decompression sickness, carbon monoxide exposure, hydrogen sulfide exposure, or cyanide exposure are all priority 2 patients. And again, if ground transport is greater than 40 minutes, transport by air. Let's now move to the priority three patient. Those patients can be transported to the closest appropriate pediatric ed.

Now, Baker Acts, a stable Baker act patient can be transported to JFK Medical Center North Campus. If that Baker ACT is unstable, transport them to the closest appropriate APED or CPED for stabilization. So, for clarification, if the patient has ingested medication or has any other medical issue, they should be transported to an APED or a cped. But if they're a simple Baker act, you can transport them to a pediatric Baker act facility. In conclusion, remember that during transport, the lieutenant shall remain in the patient care compartment, and transport time should consider factors such as traffic, weather and road conditions. Keep this protocol in mind to ensure proper care for our pediatric patients during transport. Thank you for watching and please stay safe.