Initial management and stabilization: Emergency department transport

Infants and children with congenital and acquired heart disease frequently present with nonspecific complaints, and therefore it is essential to have a high index of suspicion for a cardiac cause. This is particularly true for a neonate presenting with severe cyanosis or cardiovascular collapse. A thorough knowledge of pediatric cardiac physiology and O₂ delivery are required to accurately evaluate and effectively stabilize these patients. The safe transport of patients with known or suspected cardiac disease requires a clear understanding of the transport environment’s unique features and an appreciation of the challenges that these may pose. Effective triage and communication is essential to assessing the patient’s severity of illness and clinical stability before transport and to determining what interventions and/or therapies will be needed on arrival to the referring facility, during transport itself, and immediately upon return to the receiving institution.