CHAPTER 11 ■ INTERFACILITY TRANSPORT AND STABILIZATION JESSICA J WALL, GEORGE A (TONY) WOODWARD, NICHOLAS TSAROUHAS INTRODUCTION TO PEDIATRIC INTERFACILITY TRANSPORT Infants, children, and adolescents are commonly evaluated and transported by emergency medical services (EMS) systems worldwide That discipline of medicine is also termed prehospital care Chapter 134 Prehospital Care addresses prehospital stabilization and EMS systems Although there is often an overlap in personnel and services between prehospital and interfacility transport, this chapter will focus primarily on interfacility transport medicine and transport stabilization While pediatric transport medicine has been a formally recognized entity for approximately 25 years, it is still developing A 2013 update, published by Stroud et al., includes the discussion and results of multiple topics from a consensus conference addressing pediatric and neonatal interfacility transport Pediatric interfacility transport involves patient transfer from one medical location to another This aspect of care delivery is vital, especially with the increased regionalization and specialization of care systems, both in the United States and internationally Interfacility transport can originate from hospitals, emergency care centers, physician offices, clinics, or other medical care facilities There may not always be a clear distinction in scope of practice between interfacility and prehospital transport in terms of equipment, process, and in some instances, personnel Although transport providers care for patients with disease processes and injuries similar to those seen in emergency departments and critical care units, the environment and delivery of care differs ( Figs 11.1 and 11.2 ) Interfacility transport teams may also transport patients from the prehospital environment, while EMS may be involved in interfacility transport Differences between prehospital and interfacility transport teams may include management protocols, extrication issues, personnel types, staff education, and team experience Table 11.1 summarizes equipment common to both ground EMS and transport ambulances Interfacility transport begins with the determination of the need or desire for medical care at another institution The most common reason for acute interfacility transport is the need for advanced or specialized levels of care or services that are not available at the referring facility Examples include the need for specialized capabilities (hyperbaric oxygen or extracorporeal membrane