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Physician Connection
A Communication Service for Physicians from CHOC and CHOC at Mission. Please Note: Physician Connection is no longer being printed and is now available electronically. Please visit our blog at http://docs.chocchildrens.org for the latest articles for our physician community. You can also receive our electronic Physician Connection newsletter in your inbox by subscribing to our mailing list: http://www.choc.org/subscribe

Second Emergency Transport Services Team Meets Increasing Demand

CHOC has clearly arrived as having one of the busiest pediatric transport teams in the nation. During fiscal year 2007, CHOC transported more than 4,100 patients — a five-fold increase since 1999. Transports account for 40 percent of hospital admissions, and more than 120 facilities throughout the region refer to CHOC.

A second dedicated emergency transport services team has been added to accommodate the growing number of referrals from throughout Southern California and beyond. This team is led by physicians, and staffed with dedicated pediatric and neonatal intensive care nurses and respiratory care practitioners recruited from within CHOC. Additionally, the program has been upgraded with new ventilators, transport modules, computers and phones. The program is now housed within a dedicated space inside the new CHOC PICU.

Jason Knight, M.D., medical director of the CHOC Emergency Transport Services Team, attributes this increase to the growing regionalization of healthcare within Southern California. While most transports from outside of Orange County typically come from Riverside, Los Angeles or San Bernardino counties, it is not uncommon for the team to retrieve patients from San Diego or Central California.

“CHOC is recognized for having centers of excellence in oncology, neuroscience, cardiology and orthopaedics. This level of care is very difficult to obtain at smaller hospitals, particularly in outlying areas,” Dr. Knight says. “Our transport teams provide everything that would be provided within the walls of our hospital. They extend our ICU out to the referring institution and start the stabilization process upon our arrival at the patient’s bedside.”

Triage Tools Result In Safer Transport
Two new triage tools developed by the CHOC Emergency Transport Services Team have dramatically improved safety for patients, families and CHOC transport staff. Since implementing the code 3 triage tool, which assesses a patient’s diagnosis and level of acuity, current location and care provided, transport team composition, driving distance and traffic conditions, the number of highspeed transports with lights and sirens has dropped to less than 0.05%.

“By using this tool, we found out that more often than not, we don’t need to be going code 3. Driving faster and getting here a few minutes sooner did not make any difference in the interhospital situation. The patients still had good outcomes,” says Dr. Knight, who developed the tool with Cynthia Smith, R.N., transport coordinator, and James Cappon, M.D., medical director of CHOC Quality & Safety. “These results suggest that the risks associated with driving code 3 do not provide any true reward.” In October, Dr. Knight presented this data at the American Academy of Pediatrics 2007 National Conference and Exhibition, in San Francisco.

CHOC is using a similar tool to identify patients who may benefit from air transport, via helicopter or fixed-wing aircraft, instead of ground transportation. Patient level of stability and weather are some of the factors this tool takes into account, Dr. Knight says.

The CHOC Emergency Transport Services Team is available around the clock every day to transport critically ill or injured infants, children or adolescents to CHOC.

CHOC transport at a glance
CHOC was the first hospital in the nation to transport neonates and children on nitric oxide with high-frequency ventilation. Capabilities include:

  • Air or ground transport
  • Rapid Response
  • Physician-led critical care team departs within 30 minutes
  • ACLS/BLS team departs within 60 minutes
  • ECMO, nitric oxide and high-frequency ventilation


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chocChildren's Hospital of Orange County | UCI University of California, Irvine

Children's Hospital of Orange County is affiliated with UC Irvine Healthcare and UC Irvine School of Medicine

CHOC Children's - 1201 W La Veta Ave, Orange, CA. Phone: 714-997-3000. .