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particular patient Holt et al recently found that the PedCTAS, TPEWS, and TRAP scores are all strongly predictive of higher acuity during transport and the need for PICU admission at the receiving facility The medical capabilities of the transport system are important to assess and plan All transport teams not have equivalent levels of pediatric skills Transport services can vary from specialized pediatric teams, such as those supplied by tertiary care pediatric hospitals, to generalized transport services that transport both adults and children In addition, some teams have additional specialized capabilities, such as the ability to initiate or transport patients requiring ECMO, inhaled nitric oxide, and high-frequency ventilation or oscillation Unfortunately, there are no universal standards or regulations regarding the level of experience or expertise in pediatrics required to transport pediatric patients There are, however, accrediting agencies and standards that can be reviewed The most specific transport accreditation process for transport systems is through the Commission on Accreditation of Medical Transport Systems (CAMTS) Although this is often a voluntary appraisal of a system, certification is mandatory for licensing of some services in specific states All hospital-based teams should, however, comply with Joint Commission on Accreditation of Healthcare Organizations requirements for patient care and safety Further, the National Patient Safety Goals, first established in 2003 and updated most recently in 2019, mandates to improve patient safety through correct patient identification, improved communication, medication safety, healthcare-associated infections; transport teams are not exempt from compliance Although different types of transport systems can efficiently and safely transport pediatric patients, the referring physician is responsible for assessing the selected transport system for medical sophistication and safety As pediatric diseases and processes differ from those in adults, one should not assume a general transport service has adequate experience in pediatrics to offer the appropriate or optimal level of care In some cases, expedient patient transport by a general team may be perfectly acceptable For example, the stable trauma patient, the child with a clearly defined medical process, or the patient needing referral for a stable, non–life-threatening issue, may be adequately transported by a transport team without extensive pediatric experience Alternatively, however, when the differential diagnosis needs to be explored during the transport process, or when the patient’s condition is rapidly changing, an experienced pediatric team with critical care skills is usually preferred This process may be classified as bringing pediatric care to the patient, as opposed to getting the patient to pediatric
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