Importancia del transporte pediátrico y neonatal especializado. Situación actual en España: Hacia un futuro más equitativo y universal / Importance of specialized paediatric and neonatal transport. Current situation in Spain: Towards a more equitable and universal future

El transporte pediátrico y neonatal especializado es un recurso útil y esencial en el traslado interhospitalario de estos pacientes. Permite acercar los recursos materiales y personales de una unidad de cuidados intensivos a los hospitales comarcales donde se pueda encontrar el paciente. Los beneficios de estos equipos están muy bien demostrados en la literatura. Estas unidades deberían formar parte de los sistemas de emergencias, al mismo tiempo que sería recomendable que estuvieran constituidas por personal integrado en los hospitales terciarios con el fin de mantener las habilidades y competencias necesarias. El equipo, compuesto por médicos, enfermeros y técnicos de emergencias sanitarias, tiene que dominar tanto la fisiopatología del transporte como la del paciente crítico en este rango de edad. Es importante una alta calidad tanto humana como asistencial, por lo que la formación continuada y el reciclaje periódico serán imprescindibles para poder cumplir correctamente con los indicadores de calidad en transporte. Así mismo, es fundamental contar con vehículos propios y adaptados a su función, que permitan llevar la gran variedad de material necesario, así como la electromedicina que se requiere. Sin embargo, en España este modelo de transporte pediátrico y neonatal no está estandarizado y por lo tanto no es homogéneo: existen diferentes modelos que no siempre aportan una adecuada calidad, siendo necesaria la implantación de unidades especializadas en todo el país para garantizar un transporte sanitario de calidad a cualquier niño o neonato crítico. (AU)

Specialized paediatric and neonatal transport is a useful and essential resource in the interhospital transfer of these patients. It allows bringing the material and personal resources of an intensive care unit closer to the regional hospitals where the patient can be found. The benefits of these teams are very well demonstrated in the literature. These units should be part of the emergency systems, while it would be recommended that they would be staff integrated in the tertiary hospitals, in order to maintain the necessary skills and competencies. The team, made up of physicians, nurses and emergency medical technicians, must master both the pathophysiology of transport and that of the critical patient in this age range. A high-quality of both human and care is important, so continuous training and periodic recycling will be essential to be compliant with the quality indicators in transport. Likewise, it is essential to have specific vehicles adapted to this function, which allow carrying the wide variety of necessary material, as well as the electromedicine that is required. However, in Spain this paediatric and neonatal transport model is not standardized and, therefore, is not homogeneous: there are different models that do not always provide adequate quality, making it necessary to implement specialized units throughout the country to guarantee sanitary transport quality to any critical child or neonate. (AU)

Webpalestra COVID-19 (Coronavírus): transporte intra e extra-hospitalar de pacientes com COVID-19

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Medical devices; exemption from premarket notification; class II devices; powered patient transport. Final order.

The Food and Drug Administration (FDA) is publishing an order granting a petition requesting exemption from premarket notification requirements for powered patient transport devices commonly known as stairway chair lifts. These devices are used to assist in the transfer of a person with a mobility impairment caused by injury or other disease up and down flights of stairs. This order exempts stairway chair lifts, class II devices, from premarket notification and establishes conditions for exemption for this device that will provide a reasonable assurance of the safety and effectiveness of the device without submission of a premarket notification (510(k)). This exemption from 510(k), subject to these conditions, is immediately in effect for stairway chair lifts. All other devices classified under FDA's powered patient transport regulations, including attendant-operated portable stair-climbing chairs (which are different from wheelchairs) continue to require submission of 510(k)s. FDA is publishing this order in accordance with the section of the Food, Drug, and Cosmetic Act (the FD&C Act) permitting the exemption of a device from the requirement to submit a 510(k).

Considerations in medical ground transportation.

Physicians and nurses, therapists and specialists, case managers and patients and families each form a piece of the health care puzzle. Each party plays a vital role in patient wellness, but if patients do not or cannot get to therapy, they cannot be expected to get better. Patient transportation is improving because case managers can ensure that they have proper transportation to get to appointments locally and out of town.

Helicopter emergency medical service in Canary Islands, Spain.

This is a report on our first 2 years' experience of operating a helicopter emergency medical service in the Canary Islands, Spain. The two advanced life-support helicopters are staffed full time by a physician and a nurse. For the transport protocol, inter-hospital transport patients (secondary missions) were classified into three groups: group A, minor illnesses or injuries; group B, modified or middle critical condition; and group C, critical condition. On-scene patients (primary missions) were also divided into critical and non-critical condition. Cardiovascular and respiratory stabilization were necessary before transport. One thousand and fifty-four patients were transported, 19% of whom were primary missions and 81% of whom were secondary missions. Thirty per cent of the first group were in critical condition. The distribution of secondary missions was group A 16%, group B 44% and group C 40%. In group C, 60% of patients were mechanically ventilated, 70% needed cardiovascular drug support and 84% needed stabilization before transport. Thirty-two per cent were trauma patients and 12% neonates. The overall mortality rate was 0.8%. The cost per mission was US$2300. In the interests of safety and rationalization of the use of resources, transport of non-critical patients should be reduced. The presence of a trained physician and nursing crew and stabilization before transport could be responsible for the low mortality rate.

Who's moving the children? Pediatric transport: selection, education, and management.

Moving patients through the maze of available services within the health care system is, at best, complex. When the patient is a child and that child is seriously ill, the situation progresses from complex to critical. The expeditious and safe transport of a seriously ill child is generally assigned to a specifically designated and trained group of health care professionals. Although such transport is essential, only a few sources could be found in the literature that described the role preparation, function, or management of a pediatric transport team. Therefore, this study was undertaken to collect information from institutions that provide transport services for neonatal and pediatric patients. The purpose was to identify national trends, describe the composition and functional aspects of the transport team, and identify criteria used for selection, orientation, and training of team members. Representatives of 56 geographical and administratively diverse institutions responded to a structured telephone interview. Findings revealed two functionally distinct types of transport teams: dedicated (N = 38) and unit based (N = 18). Included in the data obtained were types and numbers of patients transported, average response time and distance, personnel composition, and educational and experiential standards for staff and management.