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Our Pediatric Transport Team did two outreach programs yesterday. They visited the ED programs at Bedford Memorial and Lynchburg General Hospital. These visits are opportunities to build an onging and collaborative relationships with our regional ED's with mulitple goals in mind. First and foremost is to aid these programs in insuring their capabilities in managing pediatric emergencies whether they be medical or surgical in nature. This includes discussions of equipment, technology, personnel, best-evidence protocols and training. We reinforce these discussions by reviewing real cases that arrive to their ED and require transport to our facility.
I must say that many of our regional ED's have done outstanding jobs at addressing these challenges over the past decade and it shows in their ability to stabilize pediatric patient while preparing for transport to our or other tertiary centers. Programs such as PALS and APLS have also assisted in this effort over the years.
That said the major challenge for the smaller regional ED's are few index cases of critical illness in the pediatric age group.
I think other ways to improve the care and preparedness in these facilities is to begin to employ the technologies we have available to bring more expertise to the bedside, ie, telemedicine. This will add another layer of support to assist the regional ED's with a live feed.
Regionalization of pediatric critical care is anothe approach that aids in the process that Dr. Ackerman has addressed in her post. Improved collaboration, coordination and communication within our region to support our regional ED's care for the sickest children is an ongoing challenge.

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