UMEM Educational Pearls

Category: Pediatrics

Title: Does the timing of patient transfer impact mortality in the pediatric trauma patient?

Keywords: pediatric trauma, transport, time to destination (PubMed Search)

Posted: 11/17/2023 by Jennifer Guyther, MD (Updated: 5/21/2024)
Click here to contact Jennifer Guyther, MD

Pediatric patients treated at pediatric specific trauma centers have improved mortality.  However, it is estimated that only 57% of patients live within 30 miles of a pediatric trauma center.  This means that many children will need to be stabilized at an adult trauma center or community hospital prior to transfer.  This study showed that > 25% of injured children were transferred to a pediatric trauma center following stabilization at another hospital.
The American College of Surgeons has previously recommended that the optimal interfacility transfer time for trauma patients is 60 minutes.
Data for this study was extracted from a database fed by over 800 trauma hospitals.  Every minute increase in the interfacility transfer time is associated with a 2% increase in risk adjusted odds of mortality among severely injured pediatric trauma patients.
Bottom line: When faced with a moderate to severely injured pediatric trauma patient, the availability and time to transport should be taken into account. If the time is > 60 minutes, then mode of transport and destination (if others are available), should be considered.


Hosseinpour H.  Interfacility Transfer of Pediatric Trauma to Higher Levels of Care: The Effect of Transfer Time and Level of Receiving Trauma Care. Journal of Trauma and Acute Care Surgery. Epub ahead of print.