Introduction

Patient transport involves some risk to the patient, transport personnel, and the public. Although pediatric transport services have been identified as safer systems than other types of medical transport, there are real hazards pertain­ing to the transportation of pediatric patients.

Fatal crashes of both ground and air vehicles do occur, and for every fatal crash, there are many dozens of nonfatal events, particularly for ground transport. When a medical transport vehicle is involved in a crash, there are direct costs of morbidity and mortality involving the patient, members of the transport team, other occupants, or members of the public as well as the indirect costs of a negative impact on the service that can be provided by the system as a whole. Injuries can result in permanent or temporary disability, and injured personnel may be unable to return to work for extended periods, forcing their organization to find and train temporary or permanent replace­ments. In addition to the direct mental and physical discomfort experienced by all the injured parties, there are stresses that flow onto the whole transport team. The hospital or vehicle provider may be liable for workman's compen­sation claims and may become involved in civil litigation regarding morbid­ity and mortality of the patient, provider, or a member of the public. In many cases, these tragic sequelae and their costs can be avoided or mitigated by adequate attention to safety.

With the increasing frequency of transports and the current limited focus on transportation systems safety, and minimal requirements to meet any proscribed safety standards, particularly for ground transport, there is increasing exposure to these risks. All safety policies, performance measure­ment, and training, both initial and ongoing, should be in keeping with the best practice approaches for other fleets or commercial vehicles and docu­mented and filed for review by regulatory agencies.