After 19-month-old Andrew Miller went into cardiac arrest in a Hagerstown restaurant two weeks ago, he was taken to a Washington County hospital where doctors quickly recognized that the toddler needed specialized care.
So they called the University of Maryland Medical Center's new transportation service for critically ill children, which dispatched a specially equipped ambulance. A doctor-and-nurse team monitored Andrew during his 1 1/4 -hour ambulance ride through fog and drizzle to the Baltimore hospital's Pediatric Intensive Care Unit.
Andrew is one of 150 critically ill children who have been transported by the new ambulance service, launched last September. It is the first service of its kind in the state, according to university medical center officials.
"It's really great having the team come from the hospital you're going to," said Judy Miller, Andrew's mother, yesterday at the medical center.
The Ellicott City boy, wearing a blue striped shirt, blue suspenders and blue bow tie, sat nonchalantly on his mother's lap, despite the glare of television lights and the chatter among the adults. He has been in the hospital since the April 17 heart attack, brought on by abnormal heart rhythms that he has endured since birth.
Asked if the new hospital-to-hospital transportation service is saving lives, Dr. Ellen Spurrier, director of the critical-care transport team, said: "We believe we are."
Medical studies, she said, have shown that the movement of patients from one point to another can trigger "critical incidents" -- the accidental detachment of monitoring equipment, for example -- that can compromise patient care.
The intensive-care team, she said, provides "the presence of qualified personnel who are constantly watching" and are trained in the ways that children's bodies respond to disease and trauma.
The team and the ambulance also carry special pediatric equipment, including respirators with tiny masks, a defibrillator that can be adjusted to the small voltages needed to restart an infant's heart, infusion pumps that can administer precise amounts of medicine and a large black box full of pharmaceuticals for children.
Before the service began, hospital officials said, doctors at outlying hospitals often would have to abandon their regular duties to ride with severely ill children. And they did so without benefit of specialized equipment.
Patients are billed for the specialized ambulance service in much the same way they were billed in the past for regular ambulance service from one hospital to another.
Karen Hardingham, a nurse and coordinator of the critical-care transport team, said that over the past winter her teams frequently were called on to carry children suffering life-threatening bouts of asthma.
Because of the advanced equipment and training the team has, she said, "sometimes by the time we get to the [hospital] the patient starts to get better."
Mrs. Miller praised Joe Dulany, the driver who brought Andrew to Baltimore from Hagerstown two weeks ago.
"He's great," she said. "He really tries to take your mind off what's going on."
Dulany is employed by the Advanced Care Ambulance Co. The firm has equipped two of its 19 vehicles to transport severely ill hTC children, said William Kraft, Advanced Care's training officer.
The university medical center has a toll-free number for its new pediatric transport service: 1-800-UMM-PICU.