Alejandre C, Vila D, Olego A, Tovar MJ, Llorens A, et al. (2019) Assessment of the Degree of Stress during Pediatric Ground Transport. Int J Crit Care Emerg Med 5:072.


© 2019 Alejandre C, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.


Assessment of the Degree of Stress during Pediatric Ground Transport

Carme Alejandre, MD1,2*, David Vila, PhD1,2, Ana Olego1, M José Tovar1, Angels Llorens1, Marta Hernández1, M Paz Larrosa1 and Elisabeth Esteban, PhD1,2

1Pediatric Transport Unit, Hospital Sant Joan de Déu, Spain

2Pediatric Intensive Care Unit (PICU), Hospital Sant Joan de Déu, Institut de Recerca H Sant Joan de Déu, Esplugues de Llobregat, Spain



To describe the stress of children during medical transport.

Design and setting

Prospective observational study of a cohort of patients transferred by the Pediatric Transport Unit of a tertiary-care Pediatric Hospital in Catalonia (Spain) from January 2014 to January 2015.

Main outcome measures

The degree of stress was assessed by a modified Comfort score just before climbing into the ambulance to the referring hospital and just before arriving at the referral hospital.


A total of 220 patients were included, of whom 135 were male (61.4%) with a median age of 2.5 months (IQR 3 days-21 months). Median transfer time was 29 minutes (IQR 13-52 minutes). Sixty-three patients needed non-invasive ventilation (28.6%). The median score before the transfer was 16 (IQR 15-19) and after it 16 (IQR 14-18). In 23 cases (10.5%) patients were accompanied by their parents in the ambulance; no statistically significant differences were observed in the value of the score (p 0.959). Sucrose was used in 45 patients (20.5%) and some type of sedation in 31 cases (14.1%). Statistically significant differences were observed in the assessment attributable to sedation (p 0.032). Verbal accompaniment was performed in 94 patients (42.7%) and physical in 95 patients (43.2%), responding favorably to it 64 and 62 patients, respectively (68.1% and 65.3%).


During pediatric transport, increased stress level of patients was not observed. The use of sedation during transport was infrequent. The verbal and physical accompaniment can be useful for stress reduction.