The State of Neonatal and Pediatric Interfacility Transport during the COVID-19 Pandemic

Stroud, Michael H; Miquel-Verges, Franscesca F; Rozenfeld, Ranna A; Holcomb, Robert G; Brown, Clare C; Myer, Keith

Background and Objectives The COVID-19 pandemic has altered the provision of healthcare, including interfacility transport of critically ill neonatal and pediatrics patients. Transport medicine faces unique challenges in the care of persons infected with the SARS-CoV-2 virus. In particular, the multitude of providers, confined spaces for prolonged time periods, varying modes (ground, rotor wing, fixed wing) of transport, and need for frequent aerosol-generating procedures place transport personnel at high risk. This study describes the clinical practices, personal protective equipment, and potential exposure risks of a large cohort of neonatal and pediatric interfacility transport teams. Methods Data for this study came from a survey distributed to members of the American Academy of Pediatrics Section on Transport Medicine. Results Fifty-four teams responded and 47 reported transporting COVID-19 positive patients. Among the 47 teams, 25% indicated having at least one team member convert to COVID-19 positive. A small percentage of teams (40% ground, 40% fixed wing, 18% rotor wing) reported allowing parental accompaniment during transport. There was no difference in teams with a positive team member among those that do (26%) and do not (25%) allow parents. There was a higher percentage of teams with a positive team member among teams that intubate (32% vs 0%) and place LMAs (34% vs 0%) during transport. Conclusions Our study shows that exceptional care during interfacility transport, including a family-centered approach, can continue during the COVID-19 pandemic. Teams must take steps to protect themselves, as well as the patients and families they serve, in order to mitigate transmission of the SARS-CoV-2 virus.