Interfacility Critical Care Transport of Maternal, Neonatal, and Paediatric Patients
At a national symposium entitled “Transport Systems moving our Children across Systems – Challenges, Barriers and Enablers”, held at CAPHC’s 2008 Annual Conference in Edmonton, conference delegates identified the need to develop national standards for the interfacility transport of critically ill maternal, neonatal, and paediatric patients.
In 2009, CAPHC established a National Transport Systems Steering Committee comprised of multidisciplinary experts from across the country that began to address this issue.
In June 2010, the Transport Systems Steering Committee initiated working groups to develop specific national standards. The Practitioner Profile Working Group, a team of Canadian neonatal and paediatric transport experts, was established to define and recommend a set of minimum standards for Canadian maternal, neonatal, and paediatric critical care transport practitioners.
Critical Care Transport Practitioners and Teams are responsible for the stabilization and safe transport of critically ill neonatal, paediatric and/or high risk maternal patients.
Unstable neonatal and paediatric patients may be classified as the following:
- Potential for or compromised airway, respiratory distress, respiratory failure and/or requiring assisted ventilation support
- Cardiovascular instability and/or need for cardiovascular support
- Altered level of consciousness
- Low birth weight and the extremely low birth weight preterm neonate
- Paediatric trauma
Unstable maternal patients may be classified as the following:
- Threatened preterm labour and/or high risk maternal conditions
Critical Care Transport teams also participate in repatriation transports.
Due to the unique and dynamic nature of each transport, critical care transport practitioners must acquire numerous competencies to meet the needs of a variety of transport scenarios. Patient outcome during transport is influenced by a multitude of decisions regarding assessment, stabilization and transport conditions. While each individual member of a transport team may not possess all of the required competencies, the critical care transport team, by the collective sum of its members’ individual skills and abilities, will meet the recommended minimum set of required competencies.
The following Transport Competencies Profile is presented by the CAPHC Transport Systems Practitioner Profile Working Group as recommendations for a minimum set of standards for Canadian maternal, neonatal, and paediatric critical care transport teams. These competencies cover a broad spectrum of requirements which, for the purposes of this Profile, have been summarized under the following seven categories:
- Professional Responsibilities
- Health and Safety
- Assessment and Diagnostics
Every critical care transport is unique. Optimal patient outcome involves maternal, neonatal, and paediatric critical care transport teams striving for and achieving best practices. Mastery of the competencies listed in this Profile by all critical care transport practitioners will promote optimal patient outcome during transport.