The critical care transport team at Children’s Hospital of Pittsburgh is truly an extension of the pediatric and neonatal intensive care units: the transport team brings ICU care to neonatal and pediatric patients at remote locations both within the tri-state referral area and beyond. The transport team plays a critical role the outcome of critical illness by initiating time sensitive therapies, like aggressive shock resuscitation, as early as possible.
Two dedicated transport teams consisting of a registered nurse and respiratory therapist are in-house at all times. Team members have extensive critical care experience as well as lengthy training specific to the transport environment. Nearly every medical intervention possible in the intensive care unit is made possible in the transport environment with specialized equipment and these highly-trained personnel. The CHP pediatric and neonatal transport team has transported patients on extracorporeal membrane oxygenation and pediatric biventricular assist devices that are not traditionally considered portable.
The RN/RT team performs the majority of transports with remote direction from a pediatric critical care or neonatal physician. Pediatric critical care and neonatal critical care fellows travel with the team when necessary, providing support for patients who require invasive procedures, complicated medical management, or are at high risk for mortality.
Medcall helps to arrange physician-to-physician contact 24 hours a day and assists with setting up transportation within the tri-state referral area as well as both national and international flights. Medcall coordinates transports by ambulance, helicopter, and fixed-wing aircraft. More than ½ of interfacility transports performed by the critical care transport team are done by air. Pilot programs using telemedicine contact with referring facilities to improve quality of communication and facilitate earlier stabilization even before transport team arrival are beginning in 2011.
The service began in 1980 as the Children’s Hospital of Pittsburgh Transport Team under the recommendation from Dr. Jeff Malatack and with the aid of Peggy Slota, RN. In that era, it was clear that the needs of pediatric patients were not being met by multi-specialty teams. In 1983, Dr. Richard Orr was appointed Medical Director of the Transport Team. He served in that position solely until 2005. It was during his tenure as medical director that specialized pediatric and neonatal critical care transports increased to their current level of about 1,400 transports per year. During this period, Dr. Orr’s groundbreaking research identified both an decreased risk of adverse events during transport and a decrease in hospital when children are transported by a pediatric/neonatal specialty team rather than an adult-oriented multispecialty team. Dr. Kate Felmet took over as medical director in 2006. Dr. Melissa Riley provides medical direction for neonatal transport issues. Carol Singleton, RN will retire from her post as transport team manager after nearly 2 decades of exemplary service.