(1108) Critical Care Transport Provider Training in Resource-Limited Settings by Peer-Led Learning

Introduction: In resource-limited settings (RLS), transport of the pediatric critically ill often faces challenges due to lack of formal provider training in transport medicine. This deficiency in preparedness is associated with higher mortality rates and inadequate initial resuscitation response and continuum to critical care. Capacity building efforts, such as personnel training and system implementation in the community, can improve access to proper critical care transport.

Methods: Pediatric Critical Care Providers from diverse geographical conditions, health care systems, and experiences in transport delivery formed a Community of Practice (CoP). We surveyed 19 Latin American countries and reported improvisation when transporting critically ill, insufficient services and absence of a formal system, and deficiency in transport training and triage. More than half of the pediatric transports were conducted by paramedics, one third included pediatricians or a pediatric nurse, and less than 20% involved a respiratory therapist. We then strategically designed a dual-goal workshop: a rapid competency development of individual providers and train-the-trainer for transport team organization, grounded in inter-professional education and teamwork principles, focused in technical and non-technical skills essential to high quality transports. We used interactive didactics on core competencies, clinical guidelines and case based simulations using rapid cycle deliberate practice to train principles and skills in crises resource management.

Results: We delivered 5 workshops in Paraguay, Mexico, El Salvador, and Dominican Republic. Participants reported improved knowledge base of pediatric critical care transport activation and process, triage system, critical communication, and knowledge and skills critical to team integration and leadership in medical crises. They highlighted the concept of an integrated system for early resuscitation in the critically ill through constant communication and identified a need for enduring educational materials accessible before hands-on training to replace in-person lectures.

Conclusions: A Pediatric Critical Care Transport CoP can support a peer-led, competency-based, blended learning model to enhance personnel training and system implementation in RLS.