Question for the group (and I will try to ask it as neutrally as possible).
Hypothetical situation - child in "severe respiratory distress" in the field
(as per a paramedic's evaluation).
Is it better for the child to be transported by paramedics 30 minutes (or
many times longer) in order to get to a "Pediatric Critical Care Center"
(may not necessarily be soley a "children's hospital") or is it better for
the child to be transported only a few minutes to a general emergency
department staffed with board certified and/or residency trained emergency
physicians?? The PCCC ED is staffed by emergency physicians but has a PICU
and intensivists and specialists. Other examples of cases like this would
include a cyanotic child or child in status epilepticus.
There are over 80 general emergency departments at your disposal and only 9
Pediatric Critical Care Centers for 10 million people with unbelievable
traffic jams at times. Large areas of your county do not have a PCCC and
therefore long transport times to PCCC's are the rule, not the exception,
for these areas. Existing policy states over 20 minute transport time
requires helicopter to be called in which can take significant amounts of
time for it to arrive on scene which can extend total transport time. It is
proposed that allowable ground transport time to a PCCC be extended to 30
minutes, at which point a helicopter would be called. I am not looking at
trauma cases, just medically ill children.
Interested in what the group thinks. Remember, I am staying neutral so tone
down the hate mail (just kidding - I can take it)
OliveView-UCLA Medical Center
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