What Happens When Your Child Needs an Ambulance, Helicopter, or Medical Transport?

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Kamey Stone (1:23): We love the questions. We welcome them. Like, I feel like it helps us build rapport. It helps the parent be at ease. And the last thing you want is someone to, like, be going into a stressful situation, especially if they're, getting into a helicopter or plane, like, you know, we want to know as much as we can about you in this short amount of time because we know, like, when you're well and you're less anxious, like, that translates to the child, And so you're an integral part of the team for us.

Unknown Speaker (1:52): Yeah. It's like that five second human connection that you make with the parent that's like, I'm gonna take the best care possible. Like, even if you can't answer a question, like, that that does everything for the parent. Hello, my friends. I'm so happy that you're here.

Unknown Speaker (2:08): I'm Katie Taylor, a certified child life specialist. And today, we're talking about something that most parents don't ever plan for, and I know that because of all the families that have shared on this podcast. What happens when your child needs to be transported to a hospital, either from your home or from hospital to hospital? And I think for a lot of families, that moment comes with so many questions, and you're so overwhelmed and usually so scared. Can I ride with my child?

Unknown Speaker (2:35): Who's in the back of the ambulance with them? What happens if they have to go by a helicopter or a plane? And how do I stay connected with my child when everything is moving so fast? In this episode, I'm joined by Cami Stone and Jacob, and they are from the Texas Children's Kangaroo Crew in Austin. They walk us through what pediatric transport actually looks like, what families may not realize ahead of time, and how their team works to care for the child while also keeping parents and caregivers informed and included.

Unknown Speaker (3:05): What stood out to me the most is how much thought goes into those small moments of connection, whether it's Jacob explaining what's happening, writing down where to go, and making sure the parents know when it's written down somewhere, and helping the parents understand they're not alone in the process. This conversation is such a helpful reminder that even in urgent and scary moments, families can feel cared for too. Let's get into it. Tell us a little bit about you, where you're from, how you fell into this amazing career of supporting families through transport.

Kamey Stone (3:41): Yeah, thank you. Kimmy Stone. My official title is Assistant Clinical Director, and I oversee the emergency center, our trauma program, and our transport team here at Texas Children's in Austin. My typical background has always been in the emergency center and ERs and ER nurse by background and love that. That is my passion.

Kamey Stone (4:08): And then when I came to Texas Children's in 2022 into this clinical director role, I was also given transport. I did not have previous transport experience at that time, and so I love a good challenge in building new systems, so I was like, okay, cool. I'll take it, And I didn't really know what it meant. And then since then, I've kind of never looked back. I've gotten to meet so many wonderful people, learn so many new things, really expand my scope as a leader and what I do.

Kamey Stone (4:42): And it's just been an honor to to be a part of it. And so really appreciative of the opportunity I was given.

Unknown Speaker (4:49): Wow. Amazing. Jacob, what about you? Tell us a little bit about yourself.

Jacob (4:54): So in 2014, I started my training in EMS. I became an EMT. I did nine one one, and I always knew I wanted to work in pediatrics, and I happened to see a job posting one day when I was at a previous job. And I was like, oh, I don't know if I have the experience. And I I was like, no.

Jacob (5:15): I'm going for it. This was my dream. So I applied, and I was able to get hired on on the Kangaroo Crew. I came from the Houston team. And then when they were opened up the hospital here in Austin, I met Kamey there, and we discussed.

Jacob (5:33): And it was a great opportunity to be a part of the expansion of Texas Children. So I applied, got hired on up here in Austin and helped grow the the, you know, the hospital itself. So it's been just amazing. I've been on the team now for eight years.

Unknown Speaker (5:49): Wow. Jacob, you said it was your dream to be an EMT. Why is that the case? What's your story?

Jacob (5:55): So actually at the age of 14, was diagnosed with type one diabetes and I was actually taken to Texas Children's as a child myself. And, you know, they helped navigate that, you know, new life that I was getting as well as with my family. And the big thing that really stuck out with Texas Children's was not only the exceptional care, but just their family centered care. My parents were involved in every aspect of my care. It was very, very hard time when I was diagnosed in December.

Jacob (6:32): And I spent that Christmas in the ICU at Texas Children's and they made it feel like I was just at home with my family. And so that stuck out to me. And I knew that at some point in my life, I wanted to end up my career in Texas Children's. I didn't know you know, at 14, I didn't know what capacity that was gonna be, but that's where I knew I was going.

Unknown Speaker (6:56): That's so incredibly powerful. I feel like children's hospitals have such a unique position and opportunity to really help families feel supported. So the fact that you felt it so much that you wanted to come back and work there says amazing things about your organization. So this is when we think about some of our listeners here on the podcast, we think about a lot of parents who, when they meet someone from a transport team, they're probably having a really bad day. They could be predicting it.

Speaker 2 (7:29): It could be, you know, they may be well years into their medical journey and know this is part of it. But could you both explain a little bit about what is a transport team comprised of? Because I think there's layers and layers of this that we don't even know as people who consume health care.

Kamey Stone (7:45): And like you said, there are layers and layers. There are multiple types of, like, teams and people who make up those teams. So I'll kind of just focus on our team and what makes up Texas Children's Kangaroo Crew. So we are a three person team. We have a transport EMT, which is Jacob's role.

Kamey Stone (8:04): We have a registered nurse and a respiratory therapist. And depending on, you know, the level of care or how sick the child is, we can add in additional team members like a nurse practitioner or a physician. And then we also do maternal transports. And so if you're a patient who's pregnant, then we would add in a nurse that specializes in maternity care. So our team can kind of grow from there, but at the core, we're a three person team in unit.

Speaker 2 (8:31): Wow. And I know it's more than When I think of transport, I'm thinking of an ambulance, but I know that it's more than just that. And but then when you think of an ambulance, you have to think about traffic and how long does it take to get from point a to point b, and are there traffic lights out over here, and what is the weather doing? Is that also a part of things you guys have to consider as a transport team?

Jacob (8:54): You know, as the transport medic on the team, you know, as soon as we get our pager goes off and we get that page that we are going out and someone needs us at another facility, we immediately start that. We start looking at the weather. We start looking in the mornings when we have our shift briefing. We go over the weather for the day, the traffic for the day, what is happening, you know, on the streets all the way around the area that we're at. And so we really, while we're gathering all of our equipment and everything to get out the door to go pick up, you know, these children, We're looking at all that.

Jacob (9:29): We look at what is the fastest and safest route to that facility to go pick up the patient. And then as well as what are we looking at time wise, you know, at bedside and then time wise to get back to the hospital.

Unknown Speaker (9:43): Wow. Are there any kind of surprising things that you see families not realize was going to happen or doesn't happen when you go to pick up their child?

Kamey Stone (9:53): I think I can answer this one because it comes up a lot. We typically do our best to bring a parent parent with us. Most of the time, majority of the time, I would say confidently well over half of our transports, the parents can come with us. I think what they don't always realize is you sit up front in the ambulance with the EMT who's driving, and you are separated while your child and the other team members are in the back, and so I think when we say you're gonna ride with us, we need to be a little bit more clear on you're gonna ride with us in the front and your child's gonna ride with us in the back, and so when they get to the ambulance, there's this moment of like, I'm not riding in the back, and so I think having that conversation when we first get there and we start talking about transport would go better than you go to climb in the back of the ambulance and we we stop you and say, Oh, you actually need to go sit in the front.

Speaker 2 (10:44): Wow. Well, my training as a child life specialist, I've worked in the ER before, talked with over 300 parents on this podcast, And I can say that's pretty unique to have the parent to be able to come with you. Why is that something that you prioritize? Like I like I

Jacob (11:01): had stated, like, that drew me to Texas Children's is we are very family centered care focused. So, especially in transport because, you know, you take your child to an outside facility and you think that they're gonna get all their care there. And sometimes they need to come to us for that higher level of care and those, you know, extra services that those other facilities don't have. So being able to include the family with that when we get there and have them along for the ride, they're seeing everything, they're included in that care, they are able to ask the questions, we focus on them as well as the patient. It really helps with giving that ease in those dark times of you don't expect your child to get sick.

Jacob (11:46): Your brain is all over the place, you're thinking about all the things. So being able to include them and have them in that transport with us is one of the big things that we focus on, you know, with our transport team.

Unknown Speaker (11:58): Jacob, has there been anything in practice for you that worked with a patient or a family member that ended up changing how you do things moving forward? Like, I know for me, like, as a child life specialist, I have a friend that she one time was preparing a child for a procedure that had nothing to do with a shot. But you know what she said? She said, let's give this a shot. And the child goes, a shot.

Unknown Speaker (12:22): And she realized from then on in, she cannot say, let's give it a shot. Any stories or things like that that really kinda changed your approach with families?

Jacob (12:31): When I first joined the team, you know, coming from EMS, everything is very fast, fast, fast. We gotta go. And so you're very focused just on that patient care. And what kinda changed my way of approaching my patients, especially on this team was we really do focus on the parent. So when we walk into a room at an outside hospital, the nurse and the respiratory therapist immediately start their assessment and get that report from the outside nurse at bedside and the doctor.

Jacob (13:01): I focus on the parent in that room. I get the consent that they're allowing us to treat and transport their their child, And then I explain to them exactly what they're gonna see in that room while we're there. And I make sure that they are comfortable to ask questions throughout our care and throughout the transport.

Kamey Stone (13:23): I think it's such a a big learning curve for those who do come from that, like, nine one one pre hospital environment, which is also very important. It's just very different worlds. And so having to train the team members to be like, we have time. Like, we have a moment to address questions, you know, and then also being very clear if something goes wrong that we're gonna focus on your child for a moment. I know you have a lot of questions.

Unknown Speaker (13:51): Hold hold that thought, and we'll come right back to those questions. And I think it's just a really big, like, mindset shift. Yeah. We've gotta prioritize time, and we've also gotta prioritize the patient.

Speaker 2 (14:04): What is different about caring for a child during transport versus when they're inside the hospital? I mean, the fact that they're in a moving vehicle, but what are some differences that families can maybe expect if they've never even been inside a hospital before and they only see primary care? What should they be aware of?

Jacob (14:24): You know, from from a, like, provider standpoint, you know, we are their safety net. We are there for them. When we're on transport, we don't have all the resources and stuff that you typically have inside the hospital. We are a 30 person team. And so we all have our roles.

Jacob (14:45): Sometimes, you know, the nurse is doing their role. The respiratory therapist is doing their role. The medic is doing their role. But and it may seem like we're not talking, but we have so highly trained together, and we've done so many simulations, and we work together, we run calls together, that we don't have to necessarily communicate to each other, but we are on the same page. We know exactly what every single person in that room is doing at that time.

Unknown Speaker (15:17): I love that. Kamey, do you have anything

Kamey Stone (15:19): to add? Yeah. I would just I would say it goes back to that safety net is and I think that's a good term you used. Right? Like, I know as a nurse, if I couldn't get an IV, I'll just maybe I'll ask the charge nurse or I'll call the ultrasound team or, you know, there's like options and options and it's like you don't have that that luxury or even thinking about child life like, oh my gosh, this kid is anxious.

Kamey Stone (15:42): Like, I wish we had more distraction techniques available. And so you kind of learn to do with what you have and make a really good use of your resources. And I would say our focus is training. You know, in those situations where you need more resources or something is different than in the hospital, you fall back to your training. And we do a lot of teamwork training to be able to take on all of those roles that you would typically see in the hospital.

Speaker 2 (16:10): Yeah, you mentioned that a little bit, Jacob, the simulation part. Can you guys talk a little bit about how that's involved in and how you make decisions about how to support families and care for them?

Jacob (16:21): Yeah, so, you know, we quarterly, we do our simulation training. We work as a team in simulation. We work on and we go through just as if on our simulation, just as if we walked into an outside facility, and we have a family there, we have the patient there, we have, you know, a bedside nurse that's giving report and stuff like that. And we go through and we work as a team, we talk through things, We have a a different scenario each time of different patients that populations that we picked up, and we really focus on our team dynamic and our team cohesiveness on getting the, you know, the best care and a lot of times, you know, just being very, very efficient with each other in those aspects and doing it in a simulation so that when we go out for those real life patients that we work the same exact way.

Unknown Speaker (17:16): I feel like we've tackled so much where you're picked up, your child's picked up, the parent may or may not be able to come. We would love for them to you would love for them to be able to come if it's appropriate. They're being taken care of as if with resources that they need and a team that they need. What happens when you actually get to the endpoint and you get to the hospital? What should families expect then?

Unknown Speaker (17:39): And maybe what are some misconceptions there? And what role can parents play to let you be able to do your job and take the best care possible of their child?

Jacob (17:47): So, you know, when we arrive in the unit, we always direct the parent over so that they can have a seat, that they can listen to what happened. The hospital, they have to admit that patient into the room that we're dropping off at. And so we have several people that come into the room. And prior to arriving at the hospital, we inform the parent of that. That's one of the great things that as a transport team for the hospital, we get to kind of give a heads up of what's gonna happen when we arrive.

Jacob (18:19): And so and we tell them, you know, you are able to ask questions while we're giving report. If you have anything additional, stuff like that. They stand right there with the patient. Again, you know, that family centered care. So we do not just push them over to the side.

Jacob (18:37): They are right there with their child as we're admitting them into that unit. And so it kinda keeps that cohesiveness that we had when we walk in at that outside facility all the way through to arriving at the hospital and following that care while their stay is here.

Unknown Speaker (18:55): That's incredible. Yeah. Think we

Kamey Stone (18:57): that our EMTs on our team do really well is we know parents are stressed, and we're telling you all this information that you have to absorb, but we also have, like, cards for them. We write down exactly what room number they're going to, on what floor of the hospital, the phone number to call that unit, where to park at the parking garage, where to enter the hospital, and so we're giving that all written down and we say like, you know, if dad's coming or mom's coming, grandma's on their way, take a picture of this card so they know exactly that information so when they, you know, don't have to memorize everything we're telling them, and so we try to make sure we have enough resources for the family as well because we know it's information overload when we're picking up and dropping off.

Speaker 2 (19:41): That's huge. We've gotten to talk about ambulance rides and what that's like. What other kind of transport can families expect if they're coming to Texas Children's in Austin?

Kamey Stone (19:53): Yeah, we have other modes of transport. So we have a plane and we have a helicopter. So those are also two other ways that you can get here. I think one thing that I have encountered when talking to parents that I find, you know, that's interesting is when you come via plane, I don't think people realize that you landed an airport and then you have to take another ambulance ride. So there's a lot of logistical, we call them legs of transport.

Kamey Stone (20:19): So when you're coming by a plane, you know, you leave that outside hospital in an ambulance. You go to that airport of whatever city you're in. You get in the plane, you land in Austin or Houston or wherever we're bringing the patient, you get back into another ambulance, and then you make it to the hospital. And so those are a lot of, like, steps that you have to go through, and I just don't think if you've never had to do that for yourself or your child, it can be a lot of steps, and it's a lot of moving parts and then a lot of, like, physical movement too. Like, you're getting in a plane.

Kamey Stone (20:51): You're getting in an ambulance. And I think we try to do our best to let them know all the steps of the transport that are gonna happen. Honestly,

Unknown Speaker (21:01): that I sound like I should know this, but I did not even consider. For some reason, I think about it like, of course, a plane can just land on a helipad, right, if there's a helicopter, but obviously that's not how it works.

Unknown Speaker (21:12): Yeah. And you're right. Like, I don't think a lot of people think about it. We think that when we think of transport in the air, we immediately go to helicopters. So it's point a to point b.

Unknown Speaker (21:21): The plane is a lot a lot more logistics involved.

Speaker 2 (21:24): I love the magic wand question here for both of you that if you could wave a magic wand and transport teams for kids all across the country could do one thing, What is one thing that Texas Children's in Austin does really well with transport that you think should continue on everywhere?

Jacob (21:46): You know, my thing is is, you know, with the expansion of Texas Children's into Central Texas, that that growth, that expansion, that reaching more and more kids throughout Texas, throughout The United States with our claim, everything, that growth, that's what I would use it for is just being able to give the care that we give here at Texas Children's and on transport to even more children across The US and Texas.

Unknown Speaker (22:18): I love that because some people don't live close to the hospital and it's necessary to get that medical care.

Kamey Stone (22:23): Exactly. Absolutely. And I think for me, not necessarily magic wand, but you mentioned on something that we do different or that we, you know, we do really well and continue to do is I think we focus on constantly being better. We wanna have good outcomes. Absolutely.

Kamey Stone (22:42): We wanna have good metrics, whatever that looks like, but that is not enough for us. We want to continue to adapt the latest technology, the safest and best modes of transport. So if we can shave off minutes and get get to children or in babies and women faster, like that is our goal and it's also doing it safely. And so I really feel like that sets us apart and that is our driving mission is it's not just about, you know, did they survive or did they not get injured? Did they get to where they needed to go?

Kamey Stone (23:16): Yes. But every transport and every year we continue to grow and invest in our program to be better and better.

Speaker 2 (23:24): Wow. What questions should parents be asking when they meet someone from a transport team?

Jacob (23:32): You know, the biggest questions is, you know, advocating, asking what's happening next. What is the plan of care? You know, how am I gonna get those updates? You know, if if a parent doesn't have the ability to ride with us, you know, how are how are you gonna let me know what's happening? How do I know if something changes?

Jacob (23:53): Okay. Where where are we going? Why are we going there? You know, just those those questions. Any really any question that's going to make you in that hard situation feel at ease.

Jacob (24:09): And, you know, no question is a question that you should feel that, oh, I shouldn't be asking this or, oh, they probably think I already know or I can just find out later. No, if you have a question, ask that question in the moment.

Kamey Stone (24:29): I would say for me, and one thing we really try to do is make sure the parent knows where my child is going and why. Right? Like, it's kind of like when you're doing a consent for a procedure. I wanna be able to hear in their terms and words that they know why we're taking their child to Texas Children's, and to me that is so important that they understand the why we're going and where we're going. We do have a lot of Texas Children's locations, and it could be really traumatizing to end up at the wrong location where you think your child is supposed to be.

Kamey Stone (25:02): Like, I could not imagine the trauma of that. And so really understanding and having them repeat back to us that they know where they're going and why they're going. That helps us feel more confident in our transport.

Unknown Speaker (25:14): Yeah. Absolutely. If every parent listening to the both of you and getting to meet, Kamey and Jacob, you want them to walk away remembering one thing about how their transport team functions or how you feel as providers. What do you want them to know?

Jacob (25:31): You know, for me, you know, each person on our team, from our leaders to us on the transport team, we love what we do. We love every aspect for it. It is a very stressful job, but we love it. And we are going to provide the best care that we can.

Unknown Speaker (25:52): I would agree. And I'll just add to that. You're not alone. Like, and you are not forgotten about in the process. And I think that can be really isolating.

Kamey Stone (26:01): If you're driving three hours because you need your car in Austin, but you live three hours away, your child is coming, you know, without you, it can be easy to feel forgotten about. And Yeah. Please know you were not forgotten about. And I think one thing that we haven't really touched on is we have an entire logistical center that is operating twenty four seven that is planning out and coordinating care in all of the transport team's movements, and that there's this full force team, carrying out the responsibility of caring for your child, and getting them safely from point a to point b.

Speaker 2 (26:39): Yeah. There's it's like those complex layers that have to exist. And from the outside looking in, it's like, oh, it's an ambulance ride. It's a helicopter ride. There's so much more to it.

Speaker 2 (26:49): And I can feel your passion for what you do even through the screen today. I have one more just kind of personal question for both of you. And what have you learned maybe about yourself as a person or as a nurse or an EMT since joining the transport team?

Jacob (27:13): I think personally for me is, you know, we are always learning. And in the medical field, the medical field is always changing. Things are advancing. We're getting new treatments, new things. So education and just being able to continue to learn is the biggest thing that I take away from my job here is that, you know, our quarterly sims, our monthly trainings that we do, those are very, very vital to what we do when we go actually pick up patients.

Unknown Speaker (27:48): Wow. Yeah. And you like that part?

Unknown Speaker (27:51): I love it. I love learning.

Kamey Stone (27:54): I love it. And so I think for me, one, like, takeaway or one thing I've learned, and I wouldn't say it's so much like I've learned and have this moment, but it's something that I keep at the forefront of, like, my mind all the time and every day is I feel like sometimes we are so disconnected from from patients and families or, you know, we're just seen as these people of moments in time in transport. And so I always remember that the decisions I make as a leader for this team, I'm responsible for not only the patients and the families, but these team members, is that, like, every decision I make behind the scenes affects real people, real families, real caregivers, real coworkers, peers, and that responsibility to create, like, a safe system and build trust during people's worst moments. It's heavy, but it's, like, it's the work that matters, and I really try to keep that with me in the good times and in the bad. Yeah.

Speaker 2 (28:56): Like for me as a parent, just knowing that there's a rapport between teammates that work together and that you like to learn and that you're constantly striving to be better just makes a really hard, terrible situation that much better. I wanna thank you both so much for your time today and the work that you do every single day. And I know you're seeing people moments in time, but if there has been a transport situation for a family and they've been on this podcast, they have talked about it because those rides stay with them. It's a part of their journey that is different than anything they ever expected from the way they exit the helicopter and what that felt like to when 911 showed up and they couldn't go with their child.

Unknown Speaker (29:40): So there's one thing we should know from your 300 plus interviews of what what's something you could teach us?

Unknown Speaker (29:47): There's one that sticks with me, and I'll send you the episode. But there is a mom, her name is, I can't remember if was Deanna Randall. I interviewed them together and they were transporting from West Texas to another hospital. And it was truly going from one system to another and the chart was in paper. And they got off the helicopter and the papers went flying everywhere.

Speaker 2 (30:11): And the mom became the sole historian for a very complex rare disease and, experience that her child had just gone through. And there was no other record other than going back and printing it out at the hospital. And so I think about her a lot. I think about her getting off that and having the pressure to always have everything in her mind at all times. And a lot of parents feel that way.

Speaker 2 (30:37): So that's one thing that I take I take with is, like, from getting off the helicopter to getting out, there's just parents carry everything with them. And you guys have kind of you've always eased my fears with this, but you're saying parents can ask and they can advocate, and they just need to know that that's okay because they don't wanna feel like they're bothering you. They don't wanna be overbearing, but there's so much that they're caring and I think it's good for the care team to remember that.

Kamey Stone (31:05): I agree. We love the questions. We welcome them. Like, I feel like it helps us build rapport. It helps the parent be at ease, and the last thing you want is someone to, like, be going into a stressful situation, especially if they're, like, getting into a helicopter or plane.

Kamey Stone (31:20): Like, you know, we want to know as much as we can about you in this short amount of time because we know, like, when you're well and you're less anxious, like, that translates to the child, and so you're you're an integral part of the team for us.

Unknown Speaker (31:36): Yeah. It's like that five second human connection that you make with the parent that's like, I'm gonna take the best care possible. Like, even if you can't answer a question, like, that that that does everything for the parent. And I think it's so simple to remember. It's hard to do because you have a job to do, but those five seconds of connecting and just saying, I've got your back.

Unknown Speaker (31:56): I care about your child right now. And then they can take a deep breath.

Kamey Stone (32:01): Yeah. I think a good one we really try to do and do well at is a lot of times when we pick up a baby that's a neonate and newly born, mom is not coming with us because mom's a patient herself. Yeah. And so the team makes every effort to take that baby to mom to make sure she gets to see the baby and gets to have a goodbye. We recently got a compliment and a thank you from a parent that we transported their newborn baby via helicopter and the team, Keith and Izzy, took a moment to take the baby to mom so mom could say goodbye and they were a family that was religious, and they asked for a moment for some of the family members who were there to pray over the baby and to have a safe flight and to the team, and they did.

Kamey Stone (32:48): They allowed that time and allowed the family to carry out their religious practices, and they, you know, reached out to just say, that meant so much to us, that you allowed us to have a moment for our beliefs, and we really trusted you as you took our baby.

Unknown Speaker (33:06): Yeah. It's huge. It's that human connection, that moment of saying, like, I recognize you have never been apart from your child before, and I am about to take them away, and I'm going to treat them like they are mine. And that just goes such a long way. And, yeah, that's incredible that they I'm imagining that was a really powerful moment for everybody there, including the team.

Unknown Speaker (33:26): Well, you both so much. The work you do is so important and I'm so grateful for you. Thank you.

Unknown Speaker (33:32): Thank you.

Unknown Speaker (33:32): Thank you. We appreciate that.

Unknown Speaker (33:34): For those of you who are joining us today, I am not a doctor. I'm not a therapist. I am a child life specialist. And the suggestions and tips and resources that I talk about with parents on this podcast may be great for you and they may not be right for you. So the most important person you can talk to about getting support is your care team, your doctor who knows your story and your child's story.

Unknown Speaker (34:00): So regardless of maybe what I mentioned or what other families mentioned here, we're not licensed therapists. We're not doctors. We're having a conversation about what the parenting journey has been like. So please keep that in mind as you listen today.

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