PEDIATRIC AND NEONATAL CRITICAL CARE TRANSPORT - A COMPARISON OF THERAPEUTIC INTERVENTIONS

Objective: To compare the therapeutic interventions provided to newbor n and pediatric patients by a dedicated combined neonatal pediatric cr itical care transport team. Method: From November 1987 through Decembe r 1989 we prospectively compared the number of therapeutic interventio ns performed by the critical care transport team on newborns and pedia tric patients, The transport team (critical care physician [PL3 or gre ater], pediatric respiratory therapist, critical care nurse), recorded all therapeutic interventions, including both procedural and pharmaco logic, for 213 newborn and 149 pediatric consecutive transports, Data were analyzed by analysis of variance or chi(2) statistic. Results: Al l patients were admitted to either the pediatric or the neonatal inten sive care unit, and over 80% of both age groups received assisted vent ilation, Newborns commonly suffered from respiratory diseases (159/213 ), while pediatric patients suffered from respiratory (52/149), centra l nervous system (28/149), and traumatic conditions (37/149), Airway m aintenance procedural interventions (intubation, ventilation) were the commonest in both groups, although more frequent in neonates, Neonate s received antibiotics and morphine (P < 0.05) while pediatric patient s received anticonvulsants and respiratory drugs (P < 0.05) more frequ ently, Newborns received significantly more interventions than pediatr ic patients (average 3.56 vs 2.93, P < 0.05), Newborns also received s ignificantly more procedural interventions (2.06 vs 1.36, P = < 0.05) including intubation (34.7% vs 15.4%, P < 0.05) and the initiation of mechanical ventilation (38% vs 22%, P < 0.05). Conclusions: Overall, n ewborns received more interventions, including intubation, and ventila tion from the transport team than did pediatric patients, Our data sug gest that combined pediatric neonatal transport teams should be prepar ed to intervene in a wide range of conditions from preterm respiratory distress to the multiply traumatized adolescent.