Patel Meral M, Hebbar Kiran B, Dugan Mark C, Petrillo Toni
From the Department of Pediatrics, Emory University School of Medicine.
Division of Critical Care Medicine, Children's Healthcare of Atlanta at Egleston, Atlanta, GA.
Pediatr Emerg Care. 2020 May;36(5):e263-e267. doi: 10.1097/PEC.0000000000001655.
The aim of this study was to assess national pediatric/neonatal specialty transport teams' composition and training requirements to determine if any current standardization exists.
This was a survey of the transport teams listed with the American Academy of Pediatrics via SurveyMonkey.
While most of the teams maintain internal criteria for team competency and training, there is large variation across team compositions. The vast majority of the teams have a nurse-led team with the addition of another nurse, medic, and/or respiratory therapist regardless of mode of transport. Many of the teams report adjusting team composition based on acuity. Fewer than 15% of teams have a physician as a standard team member. More than 80% required a minimum number of supervised intubations prior to independent practice; however, the number varied largely from as little as 3 to as many as 30. Eighty-eight percent of the teams report using simulation as part of their education program, but again there were marked differences between teams as to how it was used.
There is tremendous variability nationally among pediatric/neonatal transport teams regarding training requirements, certifications, and team composition. The lack of standardization regarding team member qualifications or maintenance of competency among specialized transport teams should be looked at more closely, and evidence-based guidelines may help lead to further improved outcomes in the care of critically ill pediatric patients in the prehospital setting.
本研究旨在评估全国儿科/新生儿专科转运团队的组成和培训要求,以确定目前是否存在任何标准化情况。
这是一项通过SurveyMonkey对美国儿科学会列出的转运团队进行的调查。
虽然大多数团队维持团队能力和培训的内部标准,但团队组成差异很大。绝大多数团队由一名护士领导,另外还有一名护士、急救医疗人员和/或呼吸治疗师,无论运输方式如何。许多团队报告根据病情严重程度调整团队组成。不到15%的团队有医生作为标准团队成员。超过80%的团队要求在独立执业前进行一定数量的监督下插管;然而,数量差异很大,少至3次,多至30次。88%的团队报告将模拟作为其教育计划的一部分,但同样,各团队在模拟的使用方式上存在显著差异。
全国儿科/新生儿转运团队在培训要求、认证和团队组成方面存在巨大差异。应更密切地关注专业转运团队在团队成员资格或能力维持方面缺乏标准化的问题,基于证据的指南可能有助于进一步改善院前环境中危重症儿科患者的护理结果。