The Children's Acute Transport Service (CATS) is a publicly funded specialised regional intensive care transport service for critically ill children. CATS is the busiest Paediatric Intensive Care Transport Service in the UK and covers the 50 District General Hospitals in the North Thames and East Anglia regions of England. CATS is part of the

Great Ormond Street Hospital for Children Great Ormond Street Hospital (informally GOSH or Great Ormond Street, formerly the Hospital for Sick Children) is a children's hospital located in the Bloomsbury area of the London Borough of Camden, and a part of Great Ormond Street Hospital ...

NHS Foundation Trust A foundation trust is a semi-autonomous organisational unit within the National Health Service in England. They have a degree of independence from the Department of Health and Social Care (and, until the abolition of SHAs in 2013, their local st ...

Background

Only a proportion of hospitals have a Paediatric Intensive Care Unit

PICU A pediatric intensive care unit (also paediatric), usually abbreviated to PICU (), is an area within a hospital specializing in the care of critically ill infants, children, teenagers, and young adults aged 0-21. A PICU is typically directed by o ...

. Therefore, most critically ill children initially present to hospitals without a PICU. Paediatric Intensive Care Transport Services are designed to provide the safe and rapid transfer of these children to a regional PICU. CATS was created in 2001 as a collaborative service for the North Thames Regional PICU's: The

Royal Brompton Hospital Royal Brompton Hospital is the largest specialist heart and lung medical centre in the United Kingdom. It is managed by Guy's and St Thomas' NHS Foundation Trust. History Consumption in the 19th Century In the 19th century, consumption was a c ...

St Mary's Hospital, London St Mary's Hospital is an NHS hospital in Paddington, in the City of Westminster, London, founded in 1845. Since the UK's first academic health science centre was created in 2008, it has been operated by Imperial College Healthcare NHS Trust ...

and

. CATS receives ~2200 referral calls and performs ~1200 critical care retrievals each year. Over 75% of these children are too unwell to breathe for themselves and require anaesthesia and a

ventilator A ventilator is a piece of medical technology that provides mechanical ventilation by moving breathable air into and out of the lungs, to deliver breaths to a patient who is physically unable to breathe, or breathing insufficiently. Ventilators ...

. A third need inotropic (

inotrope An inotrope is an agent that alters the force or energy of muscular contractions. Negatively inotropic agents weaken the force of muscular contractions. Positively inotropic agents increase the strength of muscular contraction. The term ''inot ...

) support, and about 5% require inhaled

nitric oxide Nitric oxide (nitrogen oxide or nitrogen monoxide) is a colorless gas with the formula . It is one of the principal oxides of nitrogen. Nitric oxide is a free radical: it has an unpaired electron, which is sometimes denoted by a dot in its ...

during transport. Telephone advice, liaison with sub-specialist medical services and outreach education are also important parts of the service's activity.

National Services and Aeromedical Transport

Service Level Agreements (SLA) exist with

Great Ormond Street Hospital Great Ormond Street Hospital (informally GOSH or Great Ormond Street, formerly the Hospital for Sick Children) is a children's hospital located in the Bloomsbury area of the London Borough of Camden, and a part of Great Ormond Street Hospi ...

and the

Freeman Hospital The Freeman Hospital is an 800-bed tertiary referral centre in Newcastle upon Tyne, England. The hospital is managed by the Newcastle upon Tyne Hospitals NHS Foundation Trust and is a teaching hospital for Newcastle University. History The Free ...

in Newcastle for ECMO (

extracorporeal membrane oxygenation Extracorporeal membrane oxygenation (ECMO), also known as extracorporeal life support (ECLS), is an extracorporeal technique of providing prolonged cardiac and respiratory support to persons whose heart and lungs are unable to provide an adequ ...

) retrievals. CATS also provide a paediatric intensive care transport service with Great Ormond Street Hospital for retrieval of children with Vein of Galen malformations requiring radiological ablation. 5-10% of retrievals are performed by

air ambulance Air medical services is a comprehensive term covering the use of air transportation, aeroplane or helicopter, to move patients to and from healthcare facilities and accident scenes. Personnel provide comprehensive prehospital and emergency and cri ...

. This is via both

helicopter A helicopter is a type of rotorcraft in which lift and thrust are supplied by horizontally spinning rotors. This allows the helicopter to take off and land vertically, to hover, and to fly forward, backward and laterally. These attribut ...

and

fixed-wing aircraft A fixed-wing aircraft is a heavier-than-air Aircraft, flying machine, such as an airplane, which is capable of flight using wings that generate Lift (force), lift caused by the aircraft's forward airspeed and the wing configuration, shape of ...

. For many of these urgent long distance transfers, the team works with the aircraft and the crews of

HM Coastguard His Majesty's Coastguard (HMCG) is a section of the Maritime and Coastguard Agency responsible, through the Secretary of State for Transport to Parliament, for the initiation and co-ordination of all maritime search and rescue (SAR) within th ...

helicopters.

International Referrals

CATS have moved many paediatric patients internationally.

Accreditation and awards

;CAMTS Accreditation CATS has received accreditation from the

Commission on Accreditation of Medical Transport Systems The Commission on Accreditation of Medical Transport Systems (CAMTS) (pronounced ''cames''), is an independent, non-profit agency based in Sandy Springs, South Carolina, which audits and accredits fixed-wing, rotary wing, and surface medical transp ...

(CAMTS). This independent, non-profit agency audits medical transport services against industry-established criteria. CATS accreditation is for fixed-wing and rotary wing air medical transport services as well as ground inter-facility critical care services. ;Health and Social Care Award Department of Health, Health and Social Care Award, National Winners 2005.

The Team

NHS intensive care consultants are responsible for service delivery, supervision of junior medical staff, provision of outreach education and service development. All full-time CATS consultant intensivists, cover sessions in PICU/anaesthesia to maintain competencies in their base speciality. A team of full-time CATS nurses is responsible for service delivery, co-ordination of the outreach education program, and in-house training. In addition, over 50 nurses rotate from each of the 3 PICUs to cover the rota. A team of administrators provide 24-hour cover for the Referral Hotline and co-ordinate incoming referrals, teleconferencing and communication with clinical team members. Road ambulance retrievals are provided by

St John Ambulance St John Ambulance is the name of a number of affiliated organisations in different countries which teach and provide first aid and emergency medical services, and are primarily staffed by volunteers. The associations are overseen by the interna ...

using bespoke CATS designed intensive care ambulances.

Media

CATS is the subject of an eight-part (8 x 30 minute) series called

Children's Emergency ''Children's Emergency'' is a British television documentary series. It follows the Children's Acute Transport Service (abbreviated as CATS),

, produced by

September Films September Films, a UK independent television and film production company, is a division of UK independent production and distribution group DCD Media. It specialises in factual entertainment, documentaries and features, reality programming and e ...

for

BBC One BBC One is a British free-to-air public broadcast television network owned and operated by the BBC. It is the corporation's Flagship (broadcasting), flagship network and is known for broadcasting mainstream programming, which includes BBC News ...

. It aired between 4 May and 23 June 2010.
These are some excerpts from the TV series:
YouTube
Children's Emergency Trailer
YouTube
Dr Christian Pathak saves another Child
YouTube
Dr Christian Pathak in Action
YouTube
Dr Christian Pathak on duty in Chelsea
YouTube
Dr Christian Pathak in the PICU

References

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External links

*
CATS GuidelinesCATS annual reportGreat Ormond Street Hospital for Children WebsitePaediatric Intensive Care Society Website
{{Children's Hospitals in the United Kingdom Great Ormond Street Hospital