Concern over transport of ill children

MEDICAL research has highlighted the need for a national emergency transport system for critically ill children because of the present “dangerous” arrangements in place transferring young patients across the country.

A study of seriously ill children being cared for at Cork University Hospital (CUH) found a litany of concerns when it came to transferring them to specialist units.

These included files that went missing, a lack of properly-trained medical staff accompanying the children while travelling and the lack of a 24-hour service to move critically ill kids.

The study, published in the latest edition of the Irish Medical Journal, found specialist paediatric transfer teams operating in Britain, the US, Australia and other parts of Europe had been proven to give better outcomes and improve the care of badly sick children.

In Ireland though, many children were being transferred without medical supervision – sometimes even in taxis. This was a “dangerous practice”, concluded the authors of the CUH research.

Up to 70 children under the age of 16 needing emergency transfers were tracked for the study, carried out between 2005 and 2006.

Most of the young patients had life-threatening conditions including cancer, cardiac problems, bowel and neurological problems.

Records were found to be absent in 10% of transfers. Only 1% was transferred by air ambulance, while nearly 60% were transported on the ground by ambulance having to make at least three-hour trips by road. Up to 15 of the children were actually transferred without medical supervision by private vehicle, train or taxi.

Times varied for hours of travel with over 40% having to make trips between the hours of 3pm and 6am. When they arrived at specialist hospitals, often in Dublin, the urgent services needed were often not available until the next day or much later that day.

In 15% of cases, children had to wait for more than 24 hours for their transfer after the decision had been made to move them.

There is no agreed form of documentation for transfers either, says the CUH study.

“This is an extremely unsatisfactory and a potentially dangerous situation,” it warns.

The study concludes: “Long distance transport is a major clinical risk. There is no current national standardised protocol in place with regard to the transfer of these seriously ill children. Unfortunately despite specific recommendations, many critically ill children in this country are still being transferred by non-specialised staff in an ad hoc transfer service. This is not acceptable.”

The report notes a national child transfer service needs to be in place ahead of plans for a national paediatric hospital in Dublin.