Interhospital Transport of Children with Peripheral Venous Catheters by Personal Vehicle

• Published in: Pediatrics (Evanston) 2019-08, Vol.144 (2_MeetingAbstract), p.879-879
• Main Authors: Mangus, Courtney W., Stevens, Martha, Klein, Bruce L., Costabile, Philomena, Noje, Corina, Monroe, David
• Format: Article
• Language: English
• Subjects: Acuity; Caregivers; Catheters; Children; Comfort; Complications; Demographics; Demography; Emergency medical care; Emergency medical services; Medical instruments; Medical personnel; Nursing; Pain; Patient safety; Patients; Pediatrics; Polls & surveys; Safety
• ISSN: 0031-4005; 1098-4275
• DOI: 10.1542/peds.144.2MA9.879

Purpose: Most children seeking emergency care are initially evaluated in community EDs, yet many require secondary transport to a tertiary care center for further management. Interhospital transport via ambulance vs. patient's own vehicle (POV) is considered depending on a patient's clinical needs and physiologic stability; however, it is routine practice to transport stable patients by ambulance based solely on the presence of a peripheral vascular catheter (PIV). Though not yet formally studied, commonly cited barriers to pediatric transport by POV include caregiver satisfaction, patient safety/comfort, and potential PIV complications. The purpose of this study is to examine and compare caregivers' preference, satisfaction and perceptions of comfort, safety, and ease of transport by POV vs. ambulance in children with and without PIVs. An additional objective is to describe and compare PIV-related complications and integrity during transport. Methods: This is a prospective cohort study over a 12-month period of children aged 4-17 years who presented to a single community hospital with pre-specified low-acuity medical conditions and subsequently required transfer to a tertiary pediatric hospital. Caregivers of patients with and without PIVs were given the choice of transport by POV or ambulance. Upon arrival at the tertiary center, caregivers filled out anonymous surveys assessing: 1) satisfaction, 2) perceptions on comfort, safety, and ease of trip, and 3) PIV-related complications. Surveys utilized dichotomous, 5-point Likert scale, and open text responses. PIV integrity was assessed by nurses at the receiving hospital. Descriptive statistics, Chi-square, and Fisher's exact tests were utilized to describe the patient population and to compare proportions. Results: At nine months, 54 of 58 eligible patients were enrolled. All 54 elected transport by POV, and 44 (81%) had surveys completed by their caregiver (Figure 1). Surveyed patients were 55% male, mean age was 9.0±3.9 years, and 23 (52%) had a PIV. Demographics of surveyed patients did not differ from those of the entire cohort. The majority of caregivers (>84%) had positive or very positive responses related to satisfaction, comfort, safety, and ease of transport (Table 1). Results did not differ significantly between caregivers of patients with and without PIVs. Overwhelmingly, most would recommend POV transport to a friend (92%) and would choose the same mode of transport again (95%). Caregivers of