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60 Mind the age gap

Introduction Working as part of a retrieval team, 14 -16 year old young adults always trigger a debate about the most appropriate place of care. Paediatric doctors see them as small adults whereas as the adult sector see them as larger children. One particular problem is the forgotten issue of pregnancy testing for girls age 12+. Although rates of teenage pregnancy have decreased there is great disparity between areas with Norwich rate being 48/1000 as against Surrey being 29/10001 and it is often not seen as a priority test by the referring centre. Aim The aim of the study is to see if any of the retrieval catchment area hospitals follow RCPCH guidelines2 of testing for pre referral for acute transfer to a PICU. If pregnancy is confirmed or suspected, is the patient transferred to an appropriate hospital with onsite gynaecology and maternity services. In addition, are transport services prepared for a possible adverse incident involving a pregnant patient? Method A survey of referrals from the transport database was undertaken to establish how many female teenagers were transferred; and of those referred was a HCG requested and undertaken. Referring hospitals were also asked for their policies on pregnancy testing. Results In a 6 month period none of the female teenagers referred for transport had a HCG test prior to transport. Most centres tested at 12 for elective patients but not necessarily for emergency admissions. This was in line with previous research done in emergency departments.3 Conclusion This area needs further research. Although teenage pregnancies are reducing, all retrieval services should ensure that a HCG test is undertaken as soon as advisable clinically. A prompt on the referral sheet may enable this to be a standard test that is not omitted for all females of 12 and over.