Transport Team Personnel

A variety of personnel might serve as attendants during pediatric transport including physicians, nurses, nurse practitioners, respiratory therapists, physician assistants, and paramedic-emergency medical technicians.10 Practical issues such as availability, salary costs, and the requirement for training most often govern the selection of a particular professional group. Although it would be desirable to have a physician with expertise in pediatric emergency medicine in attendance during each transport, this is rarely practical. Utilizing physicians in training is an alternative, but the competition between transport activities and other aspects of their training often makes this an unattractive alternative. An increasing number of programs now utilize specially trained nonphysician personnel exclusively.

Ideally, pediatric transport personnel would have responsibility for pediatric patients only. Unfortunately, few centers have the volume of pediatric transports or the resources to support a stand-alone team for pediatric patients. More often, the responsibility for transporting infants and small children falls to teams who also transport neonatal patients, while another team transports older children and adults. The latter model of care can result in competent patient care if special effort is devoted to preparing personnel to manage pediatric emergencies.

Training requirements for team members may vary and depend on their designated responsibilities during transport. For example, programs that utilize physicians may not need to train nonphysicians in skills related to airway management. At least one member of the team attending every patient should include an individual who is experienced in diagnosing and managing virtually all life-threatening pediatric emergencies. It is helpful to cross-train if more than one discipline (e.g., respiratory therapy and nursing) is represented on the team. In addition, all team members should have a thorough understanding of the transport environment and should be familiar with all communication devices.

Many different training strategies have been utilized to prepare transport personnel. Common to most are didactic sessions during which cognitive knowledge is attained, laboratory sessions during which technical skills are taught, and supervised patient care ( Table^-4). This training is generally followed by participation in transport accompanied by an experienced team member.

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