CASE 27
Relevant information
▪ Aircraft: Rotary-wing or fixed-wing aircraft
▪ Local resources: Local general practitioner Nurse at clinic
▪ Retrieval options: General hospital 50 minutes by helicopter. Nearest paediatric cardiac centre 2 hours by fixed-wing aircraft
▪ Other: A dedicated paediatric retrieval team is on another tasking and not available. The fixed-wing aircraft is unavailable for approximately 2 hours
Questions
27.1 What is your initial retrieval plan?
27.2 Should all secondary paediatric retrievals be carried out by a dedicated paediatric team?
On arrival, clinical information is as follows:
• The baby is alert and pink.
• P 280.
• SBP 80 mmHg.
• Capillary refill time < 2 seconds.
Discussion
27.1 Like the pre-hospital plan (see Case 3), a retrieval plan is simply a way to anticipate issues that you may find on scene and to formulate a structured plan of dealing with them. The PHR team should utilise the extra time retrieval medicine allows when travelling to the scene to formulate the plan. The plan should be divided into scene, patient and destination aspects but, as the scene is usually a medical facility and the destination hospital is usually decided in advance, it is usually better to focus the retrieval plan on patient management.
A suggested plan for this scenario would be:
• Considerations regarding age and size of child:
• Extra vigilance is required for a normally ‘adult’-focused PHR team.
• Calculate estimated weight, advanced paediatric life support drugs, fluids and predicted equipment requirements using age-based formulae prior to arrival.
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