Journal Article

8416 Paediatric ‘time critical’ transfers: an audit of neurosurgical referrals in the North East and cumbria over one year

David, Gloria, Johnson, Rebecca

2025

Overview

ObjectivesLevel 3 Paediatric Critical Care Transfers for the North East and Cumbria are provided by the North East and Cumbria Transport and Retrieval (NECTAR) team. They also provide critical care advice and guidance to referring teams for transfers especially those deemed ‘time critical’.Time critical transfers are required for children who have a life threatening clinical condition where early intervention will have a greater impact on the outcome for these children such as neurosurgical emergencies.1 NECTAR covers a large geographical area with regional hospitals up to 2.5 hours away, local teams need to be able to confidently provide urgent life-saving interventions and facilitate time critical transfers to reduce delay.The National Institute for Health and Care Excellence (NICE) recommends that patients who need critical interventions leave the sending emergency department within 30 minutes of the decision to transfer.2 We aimed to review all time critical neurosurgical referrals over a period of one year and highlighted areas of learning.MethodsWe collected data retrospectively from NECTAR system for all neurosurgical referrals between October 2022 and October 2023. We crossed referenced this data with the Paediatric Intensive Care admissions book to confirm all patients during this time frame were captured.Following this, we identified transferring teams, if deemed ‘time-critical’ after conference call with the neurosurgeons and time taken from decision to transfer to arrival at the neurosurgical centre.ResultsThere were 16 neurosurgical transfers during this period. 5 of these were transferred by NECTAR while the local teams performed 11 of the transfers.Of those transferred by NECTAR, 4 were deemed not time critical while 1 was transferred pending decision re: time critical nature. (See figure 1). The median time taken from decision to transfer to arrival at neurosurgical centre was 266 minutes (168–285). (See figure 2)10 patients were transferred using clinicians from the regional hospitals in a time critical manner while 1 patient was subsequently deemed not time critical but transferred by local team as NECTAR was unavailable (See figure 1). The median time taken from decision to transfer to arrival at neurosurgical centre was 138 minutes (59–380). (See figure 2).Abstract 8416 Figure 1NECTAR Neurosurgical referrals over one year[Image Omitted. See PDF.]Abstract 8416 Figure 2Time taken from decision to transfer to arrival at neurosurgical centre[Image Omitted. See PDF.]ConclusionThere is need for systems to be in place to maintain local skills such that critically ill patients are well managed until safely transferred to the receiving center. Regional teams could ensure systems are streamlined to encourage timely decisions and transfers as well as a review of current guidelines to ensure clearer pathways for time critical transfers.ReferencesPaediatric intensive care retrieval (Transport) https://www.england.nhs.uk/commissioning/wp-content/uploads/sites/12/2015/01/e07-spec-paedi-intens-care-retrvl-transp.pdfMajor trauma: service delivery NICE guideline [NG40] Published: 17 February 2016. https://www.nice.org.uk/guidance/ng40/chapter/Recommendations#transfer-between-emergency-departments Accessed 01 October 2024

• Publisher: BMJ Publishing Group LTD
• Subject: Careers / Conferences (Gatherings) / Medical students / Neonatal care / Pediatrics / Physicians / Summer / Summer school / Summer Schools