Mode of Transport and Patient Status Upon Arrival at a Tertiary Pediatric Emergency Department in a Developing Country: A Prospective Observational Study

Introduction In children with acute illness or injury, timely access to healthcare is crucial for optimal outcomes, including early identification, prompt stabilization, and appropriate referral. Prehospital transport practices often represent a weak link in the system and are frequently underreported. Enhancing these practices could greatly benefit pediatric care. This study aims to analyze the mode of transport and condition upon arrival of children at our hospital's pediatric emergency department. Methods This hospital-based prospective observational study was conducted from August 2019 to March 2020. Data on referral status, mode of transport, vital parameters at admission, and final outcomes in terms of survival were collected prospectively from patient admission records. Results Out of 1,658 children, 1,326 (80%) were referred from another health facility. Among these, only 10.8% received prior notification about their arrival. The most common mode of transport was a bus (39.3%), followed by locally available ambulances (24.4%), two-wheelers (15.6%), and cars (10.9%). In terms of medical conditions, 47.5% of the children had respiratory infections, 15.8% had renal ailments, and 14.1% had neurological complaints. Upon arrival, 1,214 (73.2%) were in stable condition, while 444 (26.8%) were unstable. Common alterations in vital parameters included hypothermia (16.6%), SpO2 <92% (9.9%), abnormal heart rate (32.5%), and abnormal respiratory rate (56%). Additionally, 111 (6.6%) children required CPR upon arrival. Conclusions The data highlights the need for improvements in our referral systems and the modes of transport for sick children within our population.