Physician Henry Ford Hospital, Detroit, United States
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Title: A Dual-Goal Approach to Pediatric Critical Care Transport Training in Resource-Limited Settings
Objectives: Research has shown that pediatric transports by inexperienced teams encounter high mortality and morbidity. Most providers in resource-limited settings do not get formal training in transport medicine, and thus are not equipped to provide high quality transports for critically ill children. We aimed to develop a multidisciplinary pediatric critical care transport training of pediatric providers to address this exigency.
Methods: We surveyed pediatricians from 19 Latin American countries to gain insights into the landscape and needs of transport training. From total, 70% reported absence of a formal transport system, 45% lack of general transport and triage training. Many (20%) reported having to improvise care when transporting critically ill children. More than half of the pediatric transports were made by paramedics, only one third of those used pediatricians or a pediatric nurse, and less than 20% used a respiratory therapist. To address such limitations, we strategically developed a workshop with a dual-goal: a rapid competency development of individual providers and train-the-trainer for future development of a transport team. We designed an 8-hr workshop, grounded in inter-professional education, deliberate practice and teamwork principles, training both technical and non-technical skills essential to high quality transports. Part 1: Interactive didactics on core competencies and clinical guidelines. Part 2: simulations: 4 scenarios using the rapid cycle deliberate practice to train principles and skills in crises resource management.
Results: We have delivered 3 workshops in Paraguay and Mexico for 80 participants (general pediatricians, intensivists, and nurses). Participants reported improved knowledge base of pediatric critical care transport activation and process, triage system and critical communication. Participants also expressed having acquired knowledge and skills critical to team integration and leadership in medical crises.
Conclusions: Our workshop targeting multidisciplinary pediatric critical care transport providers in resource-limited setting is proven effective in training technical and technical skills.
