posted December 02, 2024

As the winter months set in, a surge in pediatric respiratory illnesses becomes an anticipated challenge for medical professionals. Rural, community hospitals often find themselves overwhelmed by the influx of pediatric patients needing specialized care they may not be equipped to provide. The rise in pediatric respiratory illness creates a demand for air medical transport that can safely and efficiently move young patients to facilities with more advanced pediatric capabilities. We’ll dive into how Air Methods manages these intricate transports, ensuring that critically ill children receive timely and appropriate care en route to specially equipped hospitals. We’ll also highlight the work our partners at Loma Linda University Health Center are doing to ease the burden at smaller community hospitals.  

Pediatric respiratory viruses, including RSV, flu, COVID-19, and rhino enterovirus pose significant health challenges, particularly during the winter months when illnesses peak. Due to the anatomical characteristics of children’s airways which are smaller and more susceptible to obstruction, respiratory illnesses can escalate into severe distress more rapidly than adults.  

“The 2022 tripledemic, characterized by surges in RSV, influenza, and COVID cases, overwhelmed pediatric healthcare systems nationwide, leading to a critical shortage of hospital beds, said Dr. Sonea Qureshi, medical director of pediatric critical care transport at Loma Linda University Children’s Hospital. “Fortunately, trends have normalized in 2023 and 2024, with a marked decline in COVID cases and a stabilization of RSV.”  

However, a trend has emerged, as more children present with co-infections — experiencing two or three viral illnesses simultaneously. Theresa Doran, the PICU transport coordinator at Loma Linda University Children’s Hospital, highlighted this concerning development. “We are witnessing a significant increase in the number of pediatric patients who are battling multiple viral infections at once, which complicates both treatment and recovery,” said Doran. In response to these co-infections, many community hospitals have adopted high-flow nasal cannula devices to initiate oxygen therapy before transferring patients to higher-level care. This proactive approach, especially during peak respiratory illness season, has proven essential in managing care effectively.  

When community hospitals need help treating severe pediatric cases, they turn to larger facilities that have pediatric-specific resources and advanced training. This is where air medical transport steps in as a vital bridge between initial diagnosis and comprehensive treatment at specialized centers.  

Air Methods’ partnership with the pediatric medical team at Loma Linda University Children’s Hospital is one such collaboration. Serving a population of several million children across five counties, the PICU air medical transport team at Loma Linda is comprised of the Nurse, the Respiratory Therapist, and the resident. This specialized team initiates care at a referring community hospital to create seamless patient management and continuous monitoring from bedside to air transport. Pediatric patients and their families find comfort in an organized approach during what can be considered a high-stress air transfer. “With the aircraft, we are a traveling ICU for the patient, equipped with the best equipment and training,” says Respiratory Transport Manager Victor Bannis. “Onboard, the transport team is equipped with advanced life-support technologies, ranging from HFNC and conventional ventilators to advanced high-frequency ventilators and nitric oxide therapy.” 

One critical aspect of pediatric air transport during a rise in respiratory illness is the necessity for highly trained personnel who can handle the unique challenges posed by transporting sick children. The crew must be exceptionally skilled in clinical interventions and emotional intelligence to reassure worried and anxious families. 

The Loma Linda medical transport team focuses on:  

• Prioritization of Communication: The medical flight teams understand that transporting young patients often involves significant emotional strain on the child and their parents. Introducing compassionate communication is a cornerstone of their transport protocol.  

• Establishing Trust: From the moment of contact, flight crews engage in active listening, validating the concerns of parents and caregivers. This approach fosters a trusting relationship, reassuring families that their child’s safety and well-being are top priorities. 

• Timely Updates: Throughout the transport process, the team commits to providing regular updates to parents, detailing the current status of the transport, estimated time of arrival, and any changes to the plan. This transparency helps keep families informed.  
   

Looking ahead, our partnership with Loma Linda remains steadfast as we leverage advanced training through simulations to equip our teams with the skills necessary to handle real-life scenarios. We feel confident we are always prepared to meet the evolving needs of our young patients. With Air Methods’ comprehensive approach that emphasizes rigorous training and advanced equipment, pediatric respiratory transports function smoothly.   

Extensive training and equipment mean:  

• All crew members are specially trained in pediatric care, utilizing high-fidelity simulation and virtual reality techniques to enhance their skills and preparedness for real-world scenarios.  

• The clinical team relies on state-of-the-art equipment, such as the Hamilton T-1 ventilator, which features a specialized mode designed to cater to the unique physiological demands of pediatric patients. This ventilator, alongside non-invasive options like heated and humidified high-flow nasal cannula oxygen therapy, allows for effective management of respiratory conditions while minimizing invasiveness — a crucial consideration, particularly in the pediatric population.  

• The use of high-flow nasal cannula machines tends to increase, reflecting the seasonal rise in respiratory issues among children.  

• Traditional therapies, including oxygen supplementation and inhaled medications, remain integral to the treatment protocol.  

Tom Crain, clinical director at Air Methods, emphasizes the importance of collaboration and communication between transport teams and receiving facilities. “Air Methods has established comprehensive policies that facilitate timely interactions with receiving physicians,” says Crain. “We ensure that the latest advancements in pediatric care are integrated into their practice and that the highest possible level of care is consistently achieved.” Air Methods is committed to delivering exceptional and responsive care in critical situations by working closely with pediatric specialty teams. 

As the winter months usher in a surge of pediatric respiratory illnesses, air medical transport can be a vital resource, particularly within rural communities. The complexities of treating young patients, particularly those facing co-infections during peak illness season, underscore the urgent need for specialized care and rapid transport capabilities. By harnessing the advanced technologies of air medical transport and the dedicated expertise of a skilled multidisciplinary team, we ensure that critically ill children receive the timely interventions they need. Focusing on compassionate communication and trust-building, our air medical transport teams provide lifesaving medical care and support families’ emotional well-being.  

Our commitment to enhancing patient outcomes and alleviating the burden on community hospitals remains steadfast. Together, we strive to transform the challenges posed by respiratory illness into opportunities for collaboration and healthcare access.  

Learn more about clinical excellence at Air Methods and Loma Linda Children’s Hospital.