Pediatric Transport Services
Johns Hopkins Children’s Center is the officially designated pediatric shock trauma center for the State of Maryland.
The Pediatric Transport Team of pediatric critical care nurses and physicians travels by ground ambulance, helicopter and fixed wing to community hospitals across Maryland and some regions of Delaware, the District of Columbia, West Virginia and Pennsylvania to stabilize and transport children who are hemodynamically unstable to Hopkins Children’s Center, where they can receive a higher degree of specialized care. The team uses specialized equipment to monitor and provide care for children from birth through 18 years of age, transporting on average 160 patients each month. About 80 percent of the children are transported to the Pediatric Emergency Department and 20 percent are transported directly to the PICU.
Also, Hopkins Children’s Center now offers transport to pediatric heart failure patients on extracorporeal membrane oxygenation, or ECMO, at hospitals within 200 miles of Hopkins that do not have a pediatric heart transplant or ventricular assist device program. By utilizing the transport team, your referring facility has access to trauma, emergency department and PICU services at Hopkins Children’s Center.
For critical care consultation with a pediatric intensive care specialist or to request transport:
Call: 410-955-5260 or 1-800-999-PICU for out-of-state calls.
Requests for Transport
All requests for pediatric transport are received by the transport team in the Pediatric Intensive Care Unit (PICU). The team triages the call to determine the need for specialty care prior to arrival of the team. The following information will be needed:
• Patient's name, age and weight
• Clinical presentation and chief complaint
• Diagnostic studies done at your facility
• Treatment provided at your facility
• Current vital signs
• Patient's past medical history and allergies
• Routine home medications
• Isolation status and last oral intake
• Patient's insurance information for transport vendor
Preparing the Transfer Chart
To decrease the time the transport team is at your facility, prepare copies of all medical records and a hard copy of all radiology studies. The radiology department at Johns Hopkins is not always able to open up all types of electronically stored images, therefore hard copies are preferred. The transport team does not like to transport lab specimens due to the risk of breakage or potential alteration of lab results. The transport team or admitting physician will contact the lab at your facility for lab results.
For non-emergent transfers a signed consent form must be available in the chart. A telephone consent may be documented by the attending physician if the parent or guardian is not present. In an emergency, two physicians may document in the chart the emergency need for transfer and the reason consent cannot be obtained (e.g. parent is unconscious). If necessary the second physician may be the receiving physician. In emergency situations, transport will not be delayed to obtain consent.
Preparing the Patient for Transfer
1. Secure all lines and tubes. If possible, unstable patients should have two large bore IV's in place.
2. Confirm ET tube placement with exhaled carbon dioxide detector (capnography preferred) and a chest x-ray if possible. A CXR is especially important in young children.
3. All patients should be NPO for transport. Patients who are transferred may need sedation and a maintenance IV fluid. The PICU transport team can give these recommendations when consultation is initially obtained.
4. Patients who are coming to the pediatric trauma center will need to be immobilized with a collar and backboard prior to transfer. The team will immoblize the patient upon arrival however if this has already done, it will reduce the bedside time at your facility.
5. Children are at risk for hypothermia, therefore a recent temperature is helpful in determining appropriate warming measures during the transport.
Preparing the Family for Transfer
If possible, the transport team will transport one family member with the patient. If the patient is being transported by helicopter, the team will have to consider the weight of the entire team to determine if a family member will be allowed to go with the patient. Siblings will not be transported. Recorded driving directions to Hopkins Children’s Center if needed are available by calling 410-955-0166.
Patient Follow Up
Staff who cared for the patient at the sending facility may call the Transport Office at 410-502-2961 and leave a message for patient outcome information or email to JHHPedTransport@jhmi.edu. ANY CONCERNS RELATED TO THE PEDIATRIC TRANSPORT SERVICE MAY BE DIRECTED TO THE Transport Team Coordinator, Philomena Costabile at firstname.lastname@example.org, or Team Medical Director, Dr. Kristen Nelson McMillan at email@example.com, or Director, Dr. Bruce Klein at firstname.lastname@example.org.