Critical Care Transport in Pediatrics and Neonatology

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Critical Care Transport in Pediatrics and
Neonatology
California Pacific Medical Center Chris
Retajczyk, M.D.Medical Director of Pediatric
Transport Program
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Critical Care Transport in Pediatrics and
Neonatology
Our Affiliates Sutter Health physicians,
hospitals and outpatient care centers serve
patients in more than 100 communities in Northern
California, Southern Oregon and Hawaii.
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Transport Capability
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History of Medical Evacuation
Helicopter WWII
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History of Medical Evacuation
WWII Korean War
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History of Medical Evacuation
Vietnam War
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History of Medical Evacuation
Civilian Helicopter Transport Begins in 1972
Association of Air Medical Services
Two-Engine Helicopters with Instrument Flight
Rating Decreased Morbidity
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History of Medical Evacuation-Fixed Wing Medical
Transport
Since WWI-primary means of transportation of
injured over great distances.
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Consensus report for regionalizing services for
critically ill or injured children
Rationale Broad recognition of the need for
improved care Emergency medicine
historically oriented toward adult care Death
rate for trauma is higher than that of adults
with similar injuries Pediatric critical
care specialist leads to lower mortality in
PICU Special resources for optimal care of
critically ill or severely injured children are
expensive and limited in availability
Regionalization promotes more efficient use of
equipment greater availability of resources
Consensus report for regionalization of services
for critically ill or injured children. Council
of the Society of Critical Care Medicine. Crit
Care Med. Jan 200028(1)236-239.
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Consensus report for regionalizing services for
critically ill or injured children
Guidelines provided by American Academy of
Pediatrics American College of Critical Care
Medicine Society of Critical Care
Medicine EMSC System Central theme in
guidelines is to provide system of care for each
region so all children receive care they need
requires continuity between all components of
the system
Consensus report for regionalization of services
for critically ill or injured children. Council
of the Society of Critical Care Medicine. Crit
Care Med. Jan 200028(1)236-239.
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Neonates Specialized Care During Transport
Thermal Regulation Mechanical Ventilation
Glucose Homeostasis Vascular Access
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How Neonatal Transport Works
Resources COBRA Regulations Benefit of
Specialized Care
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Emergency Transport Personnel
Training, Experience, Responsibilities Medical
Director Transport Coordinator Medical
Control Physician Transport Physician
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Emergency Transport Personnel
Training, Experience, Responsibilities
Transport Nurse Transport Medic
Transport Respirator Therapist Pilots and
Drivers
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Conclusion
Where we are
Where you are
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Pediatric specialty services include
Cardiology Neurology Hematology/oncolog
y Gastroenterology Neonatology/Newborn ICU
Services include Pediatric and Neonatal
surgery Maternal care for high-risk
births Attending high-risk births
Transporting infants during first four weeks
of life
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Ronald McDonald House
Working in conjunction with California Pacific
Medical Center Provides invaluable lodging and
support during hospitalization Located nearby
Ronald McDonald House of San Francisco, Inc. 1640
Scott StreetSan Francisco, CA 94115 415-673-0891
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Exceeding Standards of Care
California Childrens Services (CCS) certified
with complete subspecialty services
Vermont-Oxford participant with consistently
highest percentiles for intact survival and
lowest for morbidity Exceeding Leapfrog
Standards for High Risk Deliveries and Neonatal
ICU Care
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Conclusion
Long history beginning with military transport
Specialized teams equipment
Special challenges of neonatal and pediatric
transport
Guidelines Council of the Society of Critical
Care Medicine
Studies confirm reduced mortality with
regionalized services
Pediatricians are satisfied with regionalized
services
Expensive/limited resources are made more
accessible to community physicians
Safety Transport associated with low levels of
collision
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Neonatology Team
Steven Goldman, M.D.Chief of California
Pacifics Division of Newborn Services Ghizala
Kaleem, M.D.Board-certified in
Neonatal-Perinatal Medicine Kathleen Lewis,
M.D.,Clinical Director of Nurseries Chris
Retajczyk, M.D.Medical Director of the Neonatal
Hospitalist Program Terri Slagle, M.D.Director
of Neonatal Outreach David Lee, M.D.Medical
Director for California Pacifics Newborn
Connections
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Pediatric Critical Care Team
California Pacific Medical Center
John Tsukahara, M.D.Pediatric Critical Care Oded
Herbsman, M.D.Pediatric Hospitalist Division
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Critical Care Transport in Pediatrics and
Neonatology
California Pacific Medical Center
Chris Retajczyk, M.D.Medical Director of
Pediatric Transport ProgramMedical Director of
Neonatal Hospitalist Program
Email cretajczyk_at_sbcglobal.net Pediatric Ward
415-600-3411Pediatric ICU 415-600-3420Newborn
Intensive Care Unit 415-600-6211
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