{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,11]],"date-time":"2026-07-11T13:34:16Z","timestamp":1783776856265,"version":"3.55.0"},"reference-count":8,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["PED"],"published-print":{"date-parts":[[2015,9]]},"abstract":"<jats:sec>\n<jats:title>OBJECT<\/jats:title>\n<jats:p>Time-critical neurosurgical conditions require urgent operative treatment to prevent death or neurological deficits. In New South Wales\/Australian Capital Territory patients\u2019 distance from neurosurgical care is often great, presenting a challenge in achieving timely care for patients with acute neurosurgical conditions.<\/jats:p><\/jats:sec>\n<jats:sec>\n<jats:title>METHODS<\/jats:title>\n<jats:p>A protocol was developed to facilitate consultant neurosurgery locally. Children with acute, time-critical neurosurgical emergencies underwent operations in hospitals that do not normally offer neurosurgery. The authors describe the developed protocol, the outcome of its use, and the lessons learned in the 9 initial cases where the protocol has been used. Three cases are discussed in detail.<\/jats:p><\/jats:sec>\n<jats:sec>\n<jats:title>RESULTS<\/jats:title>\n<jats:p>Nine children were treated by a neurosurgeon at 5 rural hospitals, and 2 children were treated at a smaller metropolitan hospital. Road ambulance, fixed wing aircraft, and medical helicopters were used to transport the Newborn and Paediatric Emergency Transport Service (NETS) team, neurosurgeon, and patients.<\/jats:p>\n<jats:p>In each case, the time to definitive neurosurgical intervention was significantly reduced. The median interval from triage at the initial hospital to surgical start time was 3:55 hours, (interquartile range [IQR] 03:29\u201305:20 hours). The median distance traveled to reach a patient was 232 km (range 23\u2013637 km). The median interval from the initial NETS call requesting patient retrieval to surgical start time was 3:15 hours (IQR 00:47\u201303:37 hours). The estimated median \u201ctime saved\u201d was approximately 3:00 hours (IQR 1:44\u20133:15 hours) compared with the travel time to retrieve the child to the tertiary center: 8:31 hours (IQR 6:56\u201310:08 hours).<\/jats:p><\/jats:sec>\n<jats:sec>\n<jats:title>CONCLUSIONS<\/jats:title>\n<jats:p>Remote urgent neurosurgical interventions can be performed safely and effectively. This practice is relevant to countries where distance limits urgent access for patients to tertiary pediatric care. This practice is lifesaving for some children with head injuries and other acute neurosurgical conditions.<\/jats:p><\/jats:sec>","DOI":"10.3171\/2015.2.peds14310","type":"journal-article","created":{"date-parts":[[2015,6,19]],"date-time":"2015-06-19T13:58:56Z","timestamp":1434722336000},"page":"340-345","source":"Crossref","is-referenced-by-count":10,"title":["Mobile pediatric neurosurgery: rapid response neurosurgery for remote or urgent pediatric patients"],"prefix":"10.3171","volume":"16","author":[{"given":"Brian K.","family":"Owler","sequence":"first","affiliation":[{"name":"Discipline of Child Health and Paediatrics, Children\u2019s Hospital at Westmead Clinical School, University of Sydney;"},{"name":"Department of Neurosurgery,"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kathryn A.","family":"Browning Carmo","sequence":"additional","affiliation":[{"name":"Discipline of Child Health and Paediatrics, Children\u2019s Hospital at Westmead Clinical School, University of Sydney;"},{"name":"Newborn and Paediatric Emergency Transport Service (NETS), New South Wales, Australia"},{"name":"Grace Centre for Newborn Intensive Care, Children\u2019s Hospital at Westmead, Sydney Children\u2019s Hospital Network, Sydney, Australia;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wendy","family":"Bladwell","sequence":"additional","affiliation":[{"name":"Newborn and Paediatric Emergency Transport Service (NETS), New South Wales, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"T. Arieta","family":"Fa\u2019asalele","sequence":"additional","affiliation":[{"name":"Newborn and Paediatric Emergency Transport Service (NETS), New South Wales, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jane","family":"Roxburgh","sequence":"additional","affiliation":[{"name":"Newborn and Paediatric Emergency Transport Service (NETS), New South Wales, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tina","family":"Kendrick","sequence":"additional","affiliation":[{"name":"Newborn and Paediatric Emergency Transport Service (NETS), New South Wales, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew","family":"Berry","sequence":"additional","affiliation":[{"name":"Newborn and Paediatric Emergency Transport Service (NETS), New South Wales, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"key":"b1-peds14310","series-title":"3101.0 - Australian Demographic Statistics, Dec 2012","author":"Australian Bureau of Statistics"},{"key":"b2-peds14310","series-title":"Emerg Med Australas","first-page":"325","article-title":"Treatment of extradural haemorrhage in Queensland: interhospital transfer, preoperative delay and clinical outcome","volume":"19","author":"Deverill","year":"2007"},{"key":"b3-peds14310","series-title":"Med J Aust","doi-asserted-by":"publisher","first-page":"617","DOI":"10.5694\/j.1326-5377.1999.tb123822.x","article-title":"Mobile intensive care services in rural South Australia","volume":"171","author":"Gilligan","year":"1999"},{"key":"b4-peds14310","series-title":"ANZ J Surg","doi-asserted-by":"publisher","first-page":"858","DOI":"10.1111\/j.1445-2197.2005.03574.x","article-title":"Transfer of intubated patients with traumatic brain injury to Auckland City Hospital","volume":"75","author":"Lind","year":"2005"},{"key":"b5-peds14310","series-title":"The Management of Acute Neurotrauma in Rural and Remote Locations. A Set of Guidelines for the Care of Head and Spinal Injuries","author":"Neurosurgical Society of Australia Inc","year":"2009"},{"key":"b6-peds14310","series-title":"Injury","doi-asserted-by":"publisher","first-page":"307","DOI":"10.1016\/0020-1383(88)90100-3","article-title":"Extradural haemorrhage: strategies for management in remote places","volume":"19","author":"Simpson","year":"1988"},{"key":"b7-peds14310","series-title":"Emerg Med J","doi-asserted-by":"publisher","first-page":"519","DOI":"10.1136\/emj.2005.028779","article-title":"Severe head injury in children: emergency access to neurosurgery in the United Kingdom","volume":"23","author":"Tasker","year":"2006"},{"key":"b8-peds14310","series-title":"ANZ J Surg","doi-asserted-by":"publisher","first-page":"852","DOI":"10.1111\/j.1445-2197.2005.03549.x","article-title":"Emergency neurosurgery by general surgeons at a remote major hospital","volume":"75","author":"Treacy","year":"2005"}],"container-title":["Journal of Neurosurgery: Pediatrics"],"original-title":[],"link":[{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg-pediatr\/16\/3\/article-p340.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg-pediatr\/16\/3\/article-p340.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg-pediatr\/16\/3\/article-p340.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,4,15]],"date-time":"2023-04-15T11:58:48Z","timestamp":1681559928000},"score":1,"resource":{"primary":{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg-pediatr\/16\/3\/article-p340.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2015,9]]},"references-count":8,"journal-issue":{"issue":"3"},"URL":"https:\/\/doi.org\/10.3171\/2015.2.peds14310","relation":{},"ISSN":["1933-0707","1933-0715"],"issn-type":[{"value":"1933-0707","type":"print"},{"value":"1933-0715","type":"electronic"}],"subject":[],"published":{"date-parts":[[2015,9]]}}}