Ulrich Terheggen1, Christian Heiring2, Mattias Kjellberg3, Fredrik Hegardt4, Martin Kneyber5,6, Maurizio Gente7, Charles C Roehr8,9, Gilles Jourdain10, Pierre Tissieres11,12, Padmanabhan Ramnarayan13,14, Morten Breindahl2, Johannes van den Berg15. 1. Department of Critical Care, Paediatric and Cardiac Intensive Care Unit, Al Jalila Children's Hospital, Dubai, United Arab Emirates. terheggen@gmx.org. 2. Department of Neonatal and Paediatric Intensive Care, Rigshospitalet, the National University Hospital in Denmark, Copenhagen, Denmark. 3. Department of Neonatal Intensive Care, Uppsala University Children's Hospital, Uppsala, Sweden. 4. Department of Pediatrics, Neonatal Intensive Care Unit, Umeå University Hospital, Umeå, Sweden. 5. Department of Paediatrics, Division of Paediatric Critical Care Medicine, Beatrix Children's Hospital, University, Medical Center Groningen, University of Groningen, Groningen, The Netherlands. 6. Critical Care, Anaesthesiology, Peri-Operative & Emergency Medicine (CAPE), University of Groningen, Groningen, The Netherlands. 7. Maternal Infant Department, Policlinico Umberto I, Sapienza University of Roma, Roma, Italy. 8. National Perinatal Epidemiology Unit Clinical Trials Unit, Department of Population Health, Medical Sciences Division, University of Oxford, Oxford, UK. 9. Newborn Services, Women's Centre, John Radcliffe Hospital, Oxford University Hospitals, NHS Foundation Trust, Oxford, UK. 10. Division of Pediatrics, Neonatal Critical Care and Transportation, Medical Center "A.Béclère", Paris Saclay University Hospitals, APHP, Paris, France. 11. Pediatric Intensive Care Unit, Bicêtre University Hospital, AP-HP, Paris Saclay University, Le Kremlin-Bicêtre, France. 12. Integrative Biology of the Cell, CNRS, CEA, Paris South University, Paris Saclay University, Gif-sur-Yvette, France. 13. Children's Acute Transport Service (CATS), Great Ormond Street Hospital, London, UK. 14. Paediatric Intensive Care Unit, St Mary's Hospital, London, UK. 15. Department of Clinical Sciences, Pediatrics, Umeå University, Umeå, Sweden.
Abstract
BACKGROUND: The 2020 novel coronavirus (SARS-Cov-2) pandemic necessitates tailored recommendations addressing specific procedures for neonatal and paediatric transport of suspected or positive COVID-19 patients. The aim of this consensus statement is to define guidelines for safe clinical care for children needing inter-facility transport while making sure that the clinical teams involved are sufficiently protected from SARS-CoV-2. METHODS: A taskforce, composed of members of the European Society of Paediatric and Neonatal Intensive Care (ESPNIC) Transport section and the European Society for Paediatric Research (ESPR), reviewed the published literature and used a rapid, two-step modified Delphi process to formulate recommendations regarding safety and clinical management during transport of COVID-19 patients. RESULTS: The joint taskforce consisted of a panel of 12 experts who reached an agreement on a set of 17 recommendations specifying pertinent aspects on neonatal and paediatric COVID-19 patient transport. These included: case definition, personal protective equipment, airway management, equipment and strategies for invasive and non-invasive ventilation, special considerations for incubator and open stretcher transports, parents on transport and decontamination of transport vehicles. CONCLUSIONS: Our consensus recommendations aim to define current best-practice and should help guide transport teams dealing with infants and children with COVID-19 to work safely and effectively. IMPACT: We present European consensus recommendations on pertinent measures for transporting infants and children in times of the coronavirus (SARS-Cov-2 /COVID-19) pandemic. A panel of experts reviewed the evidence around transporting infants and children with proven or suspected COVID-19. Specific guidance on aspects of personal protective equipment, airway management and considerations for incubator and open stretcher transports is presented. Based on scant evidence, best-practice recommendations for neonatal and paediatric transport teams are presented, aiming for the protection of teams and patients. We highlight gaps in knowledge and areas of future research.
BACKGROUND: The 2020 novel coronavirus (SARS-Cov-2) pandemic necessitates tailored recommendations addressing specific procedures for neonatal and paediatric transport of suspected or positive COVID-19patients. The aim of this consensus statement is to define guidelines for safe clinical care for children needing inter-facility transport while making sure that the clinical teams involved are sufficiently protected from SARS-CoV-2. METHODS: A taskforce, composed of members of the European Society of Paediatric and Neonatal Intensive Care (ESPNIC) Transport section and the European Society for Paediatric Research (ESPR), reviewed the published literature and used a rapid, two-step modified Delphi process to formulate recommendations regarding safety and clinical management during transport of COVID-19patients. RESULTS: The joint taskforce consisted of a panel of 12 experts who reached an agreement on a set of 17 recommendations specifying pertinent aspects on neonatal and paediatric COVID-19patient transport. These included: case definition, personal protective equipment, airway management, equipment and strategies for invasive and non-invasive ventilation, special considerations for incubator and open stretcher transports, parents on transport and decontamination of transport vehicles. CONCLUSIONS: Our consensus recommendations aim to define current best-practice and should help guide transport teams dealing with infants and children with COVID-19 to work safely and effectively. IMPACT: We present European consensus recommendations on pertinent measures for transporting infants and children in times of the coronavirus (SARS-Cov-2 /COVID-19) pandemic. A panel of experts reviewed the evidence around transporting infants and children with proven or suspected COVID-19. Specific guidance on aspects of personal protective equipment, airway management and considerations for incubator and open stretcher transports is presented. Based on scant evidence, best-practice recommendations for neonatal and paediatric transport teams are presented, aiming for the protection of teams and patients. We highlight gaps in knowledge and areas of future research.
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