Children ‘at risk’ on hospital transfers

CRITICALLY ill children who are transferred from regional centres to children’s hospitals in Dublin are being put at risk, a study has warned.

It also says a 24-hour specialist paediatric ambulance service is needed at Our Lady’s Hospital for Sick Children in Crumlin, and Temple Street, to transport seriously ill children to Dublin.

The authors of the Care of the Critically Ill Child in Irish Hospitals report warned that children are being cared for before travelling by general anaesthetists, many of whom don’t have the skills or experience required for dealing with children in need of intensive care.

“A very important element of this National Paediatric Retrieval Team would be the fact that a paediatric anaesthetist and others, such as a paediatrician, would travel to the regional centre to stabilise the child,” said one of the authors of the report, Dr Eamon Tierney.

“The anaesthetist, for example, would work on its blood pressure, blood and hook it up to a life support machine before it is put in an ambulance. Properly stabilising the child is critical.”

The study, a joint report by the Faculty of Paediatrics of the Royal College of Physicians and the Association of Anaesthetists, calls for the care of critically ill children to be improved.

It also sets out guidelines on how the country’s general hospitals can “provide optimum care” for a critically ill child, as up to 11 of them do not have paediatricians.

These include Navan, Dundalk, Monaghan, Naas, Nenagh, Mallow, Bantry, Ennis, Roscommon, Tullamore and Cashel.

The report’s authors have said even before a specialist ambulance service is set up, it is vital an experienced anaesthetist and paediatrician travel with the children on inter-hospital transfers.

However, this has proven difficult due to a shortage of paediatricians in the bigger hospitals. It’s also believed Our Lady’s Hospital has to turn away 30% of transfer requests due to a lack of intensive care nurses.

Children with life-threatening injuries following a crash or suffering meningococcal septicaemia are cases which would best benefit from the scheme.

Regional ambulances are used to transport such children to Dublin and a general anaesthetist and other medical personnel accompany them.

A Health Service Executive (HSE) spokesman said in very serious cases, a ‘snatch air ambulance’, manned with medical personnel, can fly to the regional centre.

Specialist ambulances are used for newborns aged up to six weeks and adults, but older children are outside the scope of the service.