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Szent Márton Pediatric Emergency Medical Service Foundation

Fénykép a Gyermekrohamkocsiról

The "PRAM" is waiting to be alerted.

The Short History of the Mobile Pediatric Intensive Care Ambulance Unit

After the political change in 1990, the dynamically developing hospital emergency and pediatric emergency departments drafted a more and more growing demand to set up a modern, specialized ambulance unit. The 110 year-old domestic ambulance system was neither professionally, nor technically capable of serving the needs of the gradually modernized intensive care departments, neither in the field of pre-hospital care, nor in case of inter-hospital transports. Therefore it had become necessary to establish a special ambulance unit to fit into and supplement the Hungarian ambulance care. The Szent Márton Pediatric Emergency Medical Service Foundation hit this mark and has been running the only one, specialized Mobile Pediatric Intensive Care Ambulance Unit (or the "PRAM" as it is called by the paramedics personnel) in cooperation with the Hungarian National Ambulance and Emergency Service (HNAES).

Fénykép a Központi Irányító Csoportról

The Central Dispatch Centre.

The Operation of the Mobile Pediatric Intensive Care Ambulance Unit

There are about 2100 emergency calls to the PRAM in a year, in and around Budapest. Two-thirds of the calls are rescue operations, the remaining one-third is inter-hospital transports.

The Central Dispatch Centre of the Hungarian National Ambulance and Emergency Service commands the Mobile Pediatric Intensive Care Ambulance Unit to the site of accidents where children may need emergency care. Ambulance units, working on-site, very often ask for help, in order to provide the appropriate care for children. In such a case, dispatchers command our unit, too.

The PRAM is dispatched for inter-hospital transports if an inhaled child needs to be moved from one hospital to the other, or if sudden change in the state of the child is to be expected, during the transport. The PRAM very often transports ventillated children to Budapest, from hospitals all over the country.

Fénykép a Gyermekrohamkocsi akciójáról

Attending a heavily burnt baby, after a flat was set on fire. PRAM was commanded to the site parallel with a regular Emergency Medical Unit. Personnel of the two units are working shoulder to shoulder to save the baby's life. Each pair of hand is needed in such a case!

Equipment of the Mobile Pediatric Intensive Care Ambulance Unit

The leader of the 3-member unit is always a pediatric specialist: a pediatrician or an intensive care anaesthesiologist.

We use state-of-the-art equipment. The inhalation of patients is carried out with the help of the Newport HT50 ventillator. Volume and pressure controlled inhalation can be carried out with it, in direct or assisted mode. Monitoring is facilitated by the LifePak12 ECG-defibrillator. It can be used with pulseoxymeter, capnography and blood pressure gauge modules. Pediatric paddle supplement and external pacemaker can be attached to its defibrillator.

Drug dosing is carried out by two BBraun Compact S perfusors. Patients with respiratory problems are served well by the Omron U1 electronic ultrasonic nebuliser which can be used by Micronefrin, Ventolin and Pulmicort.

The drug list of the Mobile Pediatric Intensive Care Ambulance Unit is far wider than the HNAES standard: it has many different relaxants, sedatives, narcotics, analgetics, anti-convulsion pills, anti-asthmatics and a wide range of infusion products.

The WaterJel burn dressing that is indispensable for burnt casualties as well as the intraosseous infusion needle are also integral parts of the fitting. When needed, the ambulance unit accesses the vein in central or IO way, carries out conicotomy or thoracocentesis, and uses internal or external pacemaker. It can use a large number of ambulance equipment to fix traumatic patients: adult and infant VM, limb vacuum, flexible rail, adult and infant spine board, Stifneck set.

The PRAM's base car is a Mercedes-Benz Sprinter 316CDI the furnishing of which was built at the Binz Ambulance GmbH, Germany. In addition to its powerful engine, the vehicle is equipped with shock absorbers, air-conditioning and all existing motoric and other extras.

Fénykép a Gyermekrohamkocsi akciójáról

Team of PRAM has just arrived at the CT lab, delivering a baby inhaled, in critical condition.

Professional achievements of the Mobile Pediatric Intensive Care Ambulance Unit

Since 1999, there have been over 21 thousand emergency calls recorded at the Dispatch Center of the Ambulance. Some interesting statistic data:

  • 9.8% of the calls reported infants in spasm. Every second child was found unconscious and was given intensive care and taken to an intensive department.
  • every 15th child had to be ventillated
  • 62% of the patients were younger than 3
  • a further 7.5% of the calls reported infants suffering from croup. 63% of the patients received ultrasonic nebulising with Micronefrin in the first place. Although these patients should have been taken to the intensive care department based on the croup score, thanks to on-site treatment, only 13 children had to be transported to the intensive care department and only one had to be ventillated.

The Mobile Pediatric Intensive Care Ambulance Unit carries out 17-20 infant reanimations, every year. Half of them are successful. It is quite evident, that the longer the distance and the longer it takes to arrive at the scene, the less successful the reanimation is. Therefore, the Foundation considers its most important goal to support the ambulance services by providing them training and equipment, all over the the country. For further statistic data please browse our website or contact the board of directors of the Foundation.

Fénykép a Gyermekrohamkocsi gyakorlatáról

Our personnel is practicing reanimation, using a patient simulator.

The Future of the Szent Márton Pediatric Emergency Medical Service Foundation

Beside the successful operation of the Budapest Ambulance, the Foundation puts emphasis on training as well. The primary target group of this training is the physicians working for ambulance services, emergency medical technicians and ambulance assistants. In addition, the Foundation organizes training sessions for pediatricians and professionals working in the fideld of pediatric care. The Foundation tries to support pediatric intensive care in the countryside by donating equipment as well. In 2004 it donated pediatric emergency kits to 31 HNAES ambulances.

The Szent Márton Pediatric Emergency Medical Service Foundation welcomes any suggestions for cooperation in the field of mobile pediatric care in Hungary and abroad.

Please contact the following people:

Mr. Emanuele Massimo
Chairman of board of directors
tel:+36-20-9122-795
e-mail: massimo@gyermekrohamkocsi.hu

Ms. Krisztina László
Manager of secretariat
tel: +36-20-9130-727
e-mail: laszlok@gyermekrohamkocsi.hu



Szent Márton Pediatric Emergency Medical Service Foundation

H-1089 Budapest, Orczy út 32b.
HUNGARY
tel/fax: +36-1-210-7717
e-mail: posta@gyermekrohamkocsi.hu
tax ID-number: 18162785-2-42
IBAN bank account number: HU39 1070 0079 2682 3100 5000 0005
SWIFT code: CIBHHUHB

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