Transfer of patients from a regional centre to a tertiary paediatric hospital for acute otolaryngology management: When is it necessary?

Aim: Transfer of patients from a regional to a tertiary paediatric facility is sometimes required for management of otolaryngological conditions when the expertise available locally is insufficient to deal with the complexity of the case.

Methods: A retrospective analysis was carried out over a 3-year period of all patients under 18 years of age who were transferred to the Royal Children's Hospital Melbourne, primarily for otolaryngology management, from a regional hospital with an inpatient paediatric service and located 100 km or far from the Royal Children's Hospital.

Results: Thirty-nine patients (30 male, 9 female) were identified. The majority of patients (29, 74%) required surgical management, with the most common procedures being rigid bronchoscopy with or without foreign body removal (7 patients, 24%), drainage of deep neck space infection (7 patients, 24%) and bilateral choanal atresia repair (4 patients, 13%).

Conclusion: Notwithstanding the cost and inconvenience, transfer was necessary in essentially all cases in this study for either specialist surgical management or medical management of conditions that could have otherwise escalated in acuity. By inference, it would appear that most routine acute paediatric otolaryngology conditions are managed successfully in a regional setting.