Optimal escort for interhospital transport of pediatric emergencies. The charts of 130 seriously ill or injured children transported to tertiary level intensive care were examined to determine the incidence of secondary insults incurred, as a function of escort training. Of all insults incurred, approximately 8% occurred with specialized pediatric transport escorts who were accompanied by a tertiary care physician (Group III, n = 52); 20% with specialized pediatric transport escorts alone (Group II, n = 44); and 72% with escorts who had not received specialized pediatric transport training (Group I, n = 34). Based on our results, we recommend that all transport coordinators review the qualifications and experience of their transport team members and all potential escorts to assess their ability to provide optimal care for the children they transport, particularly during long journeys, transfer by air, and when serious illness or injury is involved. 