NHS Tayside ED Guidance
Primary
Paediatric patients who are transported to PMTC from scene via Scottish Ambulance Service (SAS) or a pre-hospital medical team.
Modified Primary
Paediatric patients who are identified on-scene to have injuries likely to require PMTC care however, due to the nature of their injuries, distance or logistical factors, are transferred to a paediatric Trauma Unit (TU), Local Emergency Hospital (LEH) or community hospital. These patients will have the paediatric retrieval team mobilised before arrival at the receiving unit to assist with initial resuscitation and onward rapid transfer to PMTC.
Secondary
Paediatric patients who are seen and assessed at TU/LEH but require ongoing care that can only be provided at a PMTC. These patients may be stable, unstable or time-critical. Secondary transfers or interfacility-transfers (IFT)will be classified as per the Intensive Care Society guidelines on transfer of critically ill patients:
IFT level 1 –a facility is unable to provide immediate life-saving interventions such as resuscitation and requires the clinical assistance of the ambulance service in addition to a transport resource
IFT level 2 –a transfer is required for immediate (time-critical) life, limb or sight saving intervention in another facility
IFT level 3 –patients who do not need immediate time critical intervention but require transfer to a level of care unavailable in the current facility (no time response defined)
IFT level 4 –patients who do not fit any of the above descriptions (no time response defined)
Tertiary
Paediatric patients who are assessed at a PMTC but require ongoing specialist care that can only be provided in PMTC in another region. These can be minimised by initially involving ScotSTAR as SPOC, avoiding transfers to a place that cannot provide definitive care. The Intensive Care Society guidelines on interfacility transfers would apply for these patients also. Paediatric patients who have had treatment at a PMTC and require transfer to another PMTC in another region for rehabilitation that is closer to their residence are not considered in this document as they would be classed as repatriations.