A SIGNIFICANT proportion of children who have to be transferred to Dublin hospitals for specialist care are travelling without medical supervision, a new study has found.
The researchers, who carried out the study at Cork University Hospital (CUH), say this is “a dangerous practice” which hospital staff are being forced to adopt due to a lack of appropriate transfer services. They conclude a national transport service for all critically ill children is urgently needed.
The study, published in the latest edition of the Irish Medical Journal, looked at the cases of about 75 children who had to be transferred from CUH to Dublin, almost all to Our Lady’s Hospital for Sick Children in Crumlin, in 2005 and 2006.
While information was missing in some cases, it was established that 43 of the children were transferred by ground ambulance, one by air ambulance, and 15 (20.5 per cent) were transferred medically unsupervised by private vehicles, taxi or train. Most arrived in Dublin outside of normal working hours.
Some 15 per cent waited more than 24 hours for transfer. The authors of the research say it is imperative efforts be made to reduce delays caused by securing a bed and organising a mode of transfer. They also said the ground ambulance transfers entailed at least a three-hour journey “under sub-optimal conditions”.
Furthermore they say that staff, when they do accompany children, usually are not trained in paediatric transport. The research paper states that a nationally funded service for the retrieval of critically ill and injured children came into operation in Britain in 2001.
Specialist transport teams are also commonly used in the US, Australia and other parts of Europe. “Ireland has yet to follow suit”.
Specialised transfer teams have been proven internationally to lead to better patient outcomes and to improve care in the paediatric population. “Unfortunately despite specific recommendations, many critically ill children in this country are still being transferred by non-specialised staff in an ad hoc transfer service. This is not acceptable. There is an urgent need for a 24-hour national paediatric and neonatal transport service in Ireland.”
A national neonatal transfer team has been operational since 2001 but this is a weekday, 9am-5pm, service.