Yıl: 2022 Cilt: 9 Sayı: 2 Sayfa Aralığı: 74 - 79 Metin Dili: İngilizce DOI: 10.4274/cayd.galenos.2021.99815 İndeks Tarihi: 09-10-2022

Retrospective Evaluation of Cases Accepted by Inter-hospital Transfer to the Pediatric Emergency Clinic

Öz:
Introduction: Inter-hospital transport is an important process of pediatric emergency and pediatric intensive care; the patient is transferred to another center with the emergency medical services. Inter-hospital transport can be life-saving for pediatric patients, but the process can logistically be difficult and risky. The actions required to prevent unwanted events during transport depend mostly on the accurate and reliable data obtained. We think that research on the transport of pediatric patients is limited in our country. Our study investigated the characteristics of pediatric patients transferred to our unit by ambulance and the problems during transport. Methods: One hundred and eighty-three patients under the age of 18 who were referred to the pediatric emergency service between June 2017 and June 2019, whose data were regularly recorded, were included in our study. Data of patients who were sent to the external center for consultation via 112 were excluded. The list of the transferred patients was obtained from 112 command centers in our city and the patient records were analyzed retrospectively with the hospital information management system. Results: Fifty-nine percent of the 183 patients included in our study were male. The mean age of the patients was 62.2±39.1 months. Fourty-two percent of the patients were between 1 month and 3 years old. We found that the most frequent transports are in the spring with 42.6% and 50.9% of the transports took place between 16.00-00.00 hours. We found that the most common transported patients were pneumonia with 28.4% and respiratory distress was the most common adverse event during transport with 7.1%. Conclusion: In the transfer of pediatric patients between hospitals, every step, from the training of staff to the equipment in the ambulance, should be planned in detail. We believe that more studies are needed to examine transport protocols for children’s emergency medical services, the level of education required by the transport team, the state of the medical device used in the transport process, the patient’s pre and posttransport stability, and the safety of the patient during the transport period
Anahtar Kelime:

Çocuk Acil Kliniğine Hastaneler-arası Transferle Kabul Edilen Olguların Retrospektif Değerlendirilmesi

Öz:
Giriş: Hastaneler arası nakil çocuk acil ve çocuk yoğun bakımın önemli bir süreci olup; acil tıp hizmetleri ile hasta gerektiğinde başka bir merkeze nakledilir. Hastaneler arası nakil çocuk hastalar için hayat kurtarıcı olabilir ancak bu süreç lojistik açıdan zor ve risklidir. Nakil sırasında istenmeyen olayları engellemeye yönelik eylemlerimiz çoğunlukla elde edilen doğru ve güvenilir verilere bağlıdır. Literatürde çocuk hastaların hastaneler arası nakli ile ilgili yapılan çalışmaların kısıtlı olduğunu düşünüyoruz. Çalışmamızda ünitemize ambulansla nakledilen çocuk hastaların özelliklerini ve nakil sırasında yaşadığı sorunları araştırmayı amaçladık. Yöntemler: Haziran 2017-Haziran 2019 tarihleri arasında, 3. basamak sağlık merkezi olan hastanemiz çocuk sağlığı ve hastalıkları acil servise nakil olması kabul edilmiş 18 yaşından küçük 183 hasta alındı. Bulgular: Çalışmamıza katılan 183 hastanın %59’u erkekti. Hastaların yaş ortalamasının 62,2±39,1 ay idi. Nakledilen hastaların %42,1’i 1 ay-3 yaş arasında idi. En sık naklin %42,6 ile ilkbahar mevsiminde olduğunu ve %50,9’unun 16.00-00.00 arasında naklediğini saptadık. Transport tanıları açıdan değerlendirildiğinde %28,4 ile en sık pnömoni hastalarının nakil edildiğini ve nakil sırasında istenmeyen olay olarak %7,1 ile solunum sıkıntısı olduğunu bulduk. Sonuç: Hastaneler arası çocuk hastaların naklinde; çalışanların eğitiminden ambulansta bulunan ekipmanlara kadar her basamak ayrıntılı bir şekilde planlanmalıdır. Çocuklar için acil tıp hizmetlerinin nakil protokollerini, nakil ekibinin gereksinim duyacağı eğitim düzeyini, nakil işleminde kullanılan tıbbi cihaz durumunu, hastanın nakil öncesinde ve sonrasındaki stabilizasyonunu ve nakil süresinde hasta güvenliğini araştıran daha geniş ve kapsamlı çalışmalara ihtiyaç olduğunu düşünüyoruz.
Anahtar Kelime:

Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık
  • 1. Dieckmann RA. The EMS-EMSC Continuum. Pediatric Emergency CareSystems: Planning and Management. Baltimore, Md.: Williams & Wilkins; 1992;3-17.
  • 2. Knapp JF. American Academy of Pediatrics Out of Hospital Care of Pediatric Patients. In Knapp JF, Seidel J (eds). Childhood Emergencies in The Offices, Hospital and Community: Organizing System of Care. 2nd Ed. Elk Grove. IL; American Academy of Pediatrics; 2000: 187-01.
  • 3. Warren J, Fromm RE Jr, Orr RA, Rotello LC, Horst HM, et al. Guidelines for the ınter and intrahospital transport of critically ill patients. Crit Care Med. 2004;32:256-62.
  • 4. Kanter RK, Tompkins JM. Adverse events during interhospital transport: physiologic deterioration associated with pretransport severity of illness. Pediatrics. 1989;84:43-8.
  • 5. Barry PW, Ralston C. Adverse events occurring during interhospital transfer of the critically ill. Arch Dis Child. 1994;71:8-11.
  • 6. Woodward GA, Insoft RM, Pearson-Shaver AL, David Jaimovich, Orr RA, et al. The state of pediatric inter facility transport: consensus of the second National Pediatric and Neonatal Inter Facility Transport Medicine Leadership Conference. Pediatr Emerg Care. 2002;18:38- 44.
  • 7. Chaichotjinda K, Chantra M, Pandee U. Assessment of Interhospital Transport Care for Pediatric Patients. Clin Exp Pediatr. 2020;63:184- 8.
  • 8. Gupta P, Rettiganti M. The Quest to Optimize Pediatric Interhospital Transport. Pediatr Crit Care Med. 2018;19:591-2.
  • 9. Qiu J, Wu XL, Xiao ZH, Hu X, Quan XL, et al. Investigation of the status of interhospital transport of critically ill pediatric patients. World J Pediatr. 2015;11:67-73.
  • 10. [TUİK Sayı:33706] Available at: https://tuikweb.tuik.gov.tr/ PreHaberBultenleri.do?id=33706. December, 23 2020.
  • 11. Hamrin TH, Radell PJ, Fläring U, Berner J, Eksborg S. Shortand Long-Term Outcome in Critically Ill Children After Acute Interhospital Transport to a PICU in Sweden. Pediatr Crit Care Med. 2020;21:e414-25.
  • 12. Walls TA, Chamberlain JM, Klein BL. Factors associated with emergency department discharge after pediatric interhospital transport: a role for outreach education? Pediatr Emerg Care. 2015;31:10-4.
  • 13. Soysal DD, Karaböcüoğlu M, Citak A, Uçsel R, Köroğlu T, et al. Interhospital transport of pediatric patients requiring emergent care: current status in Turkey. Ulus Travma Acil Cerrahi Derg. 2004;10:168-72.
  • 14. Hatherill M, Waggie Z, Reynolds L, Argent A. Transport of critically ill children in a resource limited setting. Intensive Care Med. 2003;29:1547-54.
  • 15. Ligtenberg JJM, Arnold LG, Stienstra Y, Van Der Werf TS, Meertens JHJM, et al. Quality of interhospital transport of critically ill patients: a prospective audit. Crit Care. 2005;9:R446-51.
  • 16. Abdel-Latif ME, Berry A. Analysis of the retrieval times of a centralised transport service, New South Wales, Australia. Arch Dis Child. 2009;94:282-6.
  • 17. Ramnarayan P. Measuring the performance of an inter-hospital transport service. Arch Dis Child. 2009;94:414-6.
  • 18. Stroud MH, Prodhan P, Moss MM, Anand KJ. Redefining The Golden Hour in Pediatric Transport. Pediatr Crit Care Med. 2008;9:435-7.
APA ÇELİK T, Güzel S, Battal F (2022). Retrospective Evaluation of Cases Accepted by Inter-hospital Transfer to the Pediatric Emergency Clinic. , 74 - 79. 10.4274/cayd.galenos.2021.99815
Chicago ÇELİK Taylan,Güzel Sinan,Battal Fatih Retrospective Evaluation of Cases Accepted by Inter-hospital Transfer to the Pediatric Emergency Clinic. (2022): 74 - 79. 10.4274/cayd.galenos.2021.99815
MLA ÇELİK Taylan,Güzel Sinan,Battal Fatih Retrospective Evaluation of Cases Accepted by Inter-hospital Transfer to the Pediatric Emergency Clinic. , 2022, ss.74 - 79. 10.4274/cayd.galenos.2021.99815
AMA ÇELİK T,Güzel S,Battal F Retrospective Evaluation of Cases Accepted by Inter-hospital Transfer to the Pediatric Emergency Clinic. . 2022; 74 - 79. 10.4274/cayd.galenos.2021.99815
Vancouver ÇELİK T,Güzel S,Battal F Retrospective Evaluation of Cases Accepted by Inter-hospital Transfer to the Pediatric Emergency Clinic. . 2022; 74 - 79. 10.4274/cayd.galenos.2021.99815
IEEE ÇELİK T,Güzel S,Battal F "Retrospective Evaluation of Cases Accepted by Inter-hospital Transfer to the Pediatric Emergency Clinic." , ss.74 - 79, 2022. 10.4274/cayd.galenos.2021.99815
ISNAD ÇELİK, Taylan vd. "Retrospective Evaluation of Cases Accepted by Inter-hospital Transfer to the Pediatric Emergency Clinic". (2022), 74-79. https://doi.org/10.4274/cayd.galenos.2021.99815
APA ÇELİK T, Güzel S, Battal F (2022). Retrospective Evaluation of Cases Accepted by Inter-hospital Transfer to the Pediatric Emergency Clinic. Çocuk Acil ve Yoğun Bakım Dergisi, 9(2), 74 - 79. 10.4274/cayd.galenos.2021.99815
Chicago ÇELİK Taylan,Güzel Sinan,Battal Fatih Retrospective Evaluation of Cases Accepted by Inter-hospital Transfer to the Pediatric Emergency Clinic. Çocuk Acil ve Yoğun Bakım Dergisi 9, no.2 (2022): 74 - 79. 10.4274/cayd.galenos.2021.99815
MLA ÇELİK Taylan,Güzel Sinan,Battal Fatih Retrospective Evaluation of Cases Accepted by Inter-hospital Transfer to the Pediatric Emergency Clinic. Çocuk Acil ve Yoğun Bakım Dergisi, vol.9, no.2, 2022, ss.74 - 79. 10.4274/cayd.galenos.2021.99815
AMA ÇELİK T,Güzel S,Battal F Retrospective Evaluation of Cases Accepted by Inter-hospital Transfer to the Pediatric Emergency Clinic. Çocuk Acil ve Yoğun Bakım Dergisi. 2022; 9(2): 74 - 79. 10.4274/cayd.galenos.2021.99815
Vancouver ÇELİK T,Güzel S,Battal F Retrospective Evaluation of Cases Accepted by Inter-hospital Transfer to the Pediatric Emergency Clinic. Çocuk Acil ve Yoğun Bakım Dergisi. 2022; 9(2): 74 - 79. 10.4274/cayd.galenos.2021.99815
IEEE ÇELİK T,Güzel S,Battal F "Retrospective Evaluation of Cases Accepted by Inter-hospital Transfer to the Pediatric Emergency Clinic." Çocuk Acil ve Yoğun Bakım Dergisi, 9, ss.74 - 79, 2022. 10.4274/cayd.galenos.2021.99815
ISNAD ÇELİK, Taylan vd. "Retrospective Evaluation of Cases Accepted by Inter-hospital Transfer to the Pediatric Emergency Clinic". Çocuk Acil ve Yoğun Bakım Dergisi 9/2 (2022), 74-79. https://doi.org/10.4274/cayd.galenos.2021.99815