P1070 - A Descriptive Analysis of Pediatric Transports throughout the United States Pacific Command

Background
The United States Pacific Command (PACOM) has over 375,000 military personnel, civilian employees, and their dependents. Routine pediatric care is available in theater, but pediatric subspecialty, surgical, and intensive care often requires patient movement. Transfer is frequently performed by military air evacuation teams and intermittently augmented by civilian services. Pediatric care requires special training and equipment, yet most transports are staffed by non-pediatric specialists. We seek to describe the epidemiology of pediatric transport missions in PACOM.

Methods
We conducted a retrospective review of all patients less than 18 years old transported within PACOM and logged into the Transportation Command Regulating and Command & Control Evacuation System (TRAC2ES) database from June 2008 through June 2018. Data is reported using descriptive statistics. Patients were categorized into 4 age groups: neonatal (<30 days), infant (31-364 days), young children (1-8 years), and older children (9-17 years).

Results
During the study period, 687 out of 4217 (16.3%) transports were children. Median age was 4 years (IQR 6 months-8 years) and 654 (95.2%) were transported via military fixed-wing aircraft. There were 219 (31.9%) neonatal, 162 (23.6%) infants, 133 (19.4%) young children, and 173 (25.2%) older children. Neonates were more likely to be evacuated as urgent status than older children. Most common diagnoses encountered were respiratory, cardiac, or abdominal, although older children had a higher percentage of psychiatric diagnoses (28%). Mechanical ventilation was used in 118 (17.2%) patients, and 75 (63.6%) of these patients were neonates.

Conclusions
Within TRAC2ES, nearly 1 in 6 encounters were patients <18 years, with neonates or infants representing 1 in 12 encounters. Slightly more than 1 in 6 pediatric patients required intubation for transport. Given the specialized training and equipment needed to care for pediatric patients, teams must be adequately trained and equipped.