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Providing advanced care on the fly, Pediatric Critical Care Transport team reaches a milestone

At 10:42 pm March 4, Yale New Haven Children’s Hospital’s Critical Care Transport program marked a milestone – nearly a half a mile in the air. The program recorded its 100th patient transport via helicopter since the first on Aug. 17, 2016. With COVID-19 ramping up in March, program leaders didn’t realize until later they’d reached 100 flights.

Since the 1990s, the Pediatric Critical Care Transport team has been providing ICU-level care during ambulance transport from hospitals throughout the state and region. In 2016, the children’s hospital added Yale New Haven Health’s SkyHealth helicopter to the transport program.

“We can provide that same level of care in the helicopter, but get patients to Yale New Haven Children’s Hospital in a fraction of the time – 12 to 15 minutes, versus an hour or longer by ambulance,” said Jason Malia, RN, YNHCH clinical program director of Transport, Emergency, Perioperative and Primary Care services.

The Pediatric Critical Care Transport program is one of three Yale New Haven transport teams; the others are YNHH’s adult Critical Care Transport and YNHCH’s Neonatal Transport programs.

Caring for a critically ill child is precarious under any circumstances. Doing it a couple thousand feet in the air and in less than 22 square feet of space jam-packed with equipment, supplies and up to three other adults is a feat. To make airborne care less cumbersome, “we do as much as possible on the ground, before takeoff,” said Tracie Battipaglia, RN, flight nurse.

Whether traveling by helicopter or ambulance, YNHCH’s Pediatric and Neonatal Critical Care Transport teams are available 24/7. Each year, the teams complete approximately 900 transports, including bringing infants and children from hospitals throughout Connecticut and the region to YNHCH for specialized care, and returning patients to the referring hospitals.

Historically, 40 percent of these patients have severe respiratory conditions, 20 percent suffer from neurologic conditions such as seizures and 10 percent are trauma patients. The ambulances and helicopters contain sophisticated equipment such as pediatric ventilators, defibrillators, intubation equipment and advanced hemodynamic monitoring equipment.

Pediatric Critical Care Transport nurses and paramedics have experience in pediatric intensive care and/or pediatric emergency care. Their extensive training includes advanced simulation, led by Thomas Martin, RN, Pediatric Critical Care program manager, and John Giuliano Jr., MD, director, Critical Care Transport Services, and associate medical director, YNHCH Pediatric Intensive Care Unit. Because their jobs require advanced airway management skills, paramedics and nurses also train in YNHCH operating rooms with pediatric anesthesiologists and certified nurse anesthetists. Flight nurses and flight paramedics undergo additional training to work on the helicopter.

“For most of our nurses and paramedics, this is the ultimate challenge,” Martin said. “You’re going into an unfamiliar hospital, picking up a critically ill child, and it’s you and your partner providing the care. There’s a lot of autonomy.”

“This is an extension of our practice,” added flight nurse Alistair Holmes, RN, who worked in the PICU before joining the transport team. “We’re bringing ICU-level care to the patient.”

Ian Dennen is an experienced paramedic who joined the flight team in May. A father of four, he believes his paramedic and parenting experience help him understand his young patients’ fears and how to calm them. He and other team members often check on their patients after bringing them to YNHCH.

“It’s so rewarding to be able to follow the kids from their admission to the hospital to their discharge,” Dennen said.