Definition of a time critical transfer 

Transfer of a patient for life, limb or organ saving treatment when the time taken to provide this treatment is a critical factor in outcome. 

Principles 

1. Acceptance by the regional centre is NOT dependent on bed availability. 
2. Time critical transfer should normally be provided by the referring hospital team NOT Embrace. 

Early senior input (at least registrar / ST4 level) is essential to ensure that: 

• The child meets clinical criteria for a time critical transfer. 
• The receiving registrar or consultant is present when the child arrives in Leeds. 
• Emergency and definitive treatment is delivered as quickly and safely as possible. 

Process 

Time critical referrals can be made via direct clinician-to-clinician phone call. 

Prior to the referral call

• Appropriate senior review of the patient must take place locally. 
• Critically ill children may be referred via Embrace to facilitate a conference call. Resuscitation, stabilisation and preparation for transfer should continue in parallel to the referral call. If time critical transfer by the referring hospital is required this will be clearly stated by the Embrace consultant during the call. 
• Refer to the on call teams in Leeds via the usual referral pathways. This is normally via the registrar for the specialty as they are resident in the hospital. 

During the referral call: 

• After local consultant review, the referring registrar or consultant should speak with the registrar in Leeds Children’s Hospital who will assist in making a decision regarding urgency of transfer and definitive treatment. If the registrar in Leeds is unavailable then this call should be escalated to the consultant to avoid delays. 
• The receiving registrar or consultant should inform the transfer team of the receiving area within Leeds (which may be ED Resus, theatres, PICU, or a ward) 
• The Children’s Hospital Bed Co-Ordinator should also be informed 
• If critical care input is required, the Paediatric Intensive Care Consultant should be included in the call 
• Please signpost the referring team to the STOPP (Safe Transfer of Paediatric Patient) assessment tool via the Embrace website in the “Key Documents” section. 

Destination 

The Leeds team may request that the patient is brought to the Leeds General Infirmary (LGI) Paediatric Emergency Department (ED) for initial stabilisation before onward transfer to Critical Care or Theatres. The receiving Leeds team should then contact the LGI ED consultant

Resourses

• EMBRACE – site
• Full PDF
• Leeds site

EMBRACE

• 0114 268 8180
• Guidance

Y&H Paed Critical Care

• Guidance
• STOPP protocol

Drugs:

• Paeds Drug Chart
• Trust guide
• Remember: Midazolam 10mg/2ml is used(not the 5mg/5ml we have  in ED)
  • Found in theatres control drug cupboard (see trust guide)