Recommendations on the skills profile and standards of the neonatal transport system in Spain

Lucas, Raquel; Boix, Héctor; García, Laura Sánchez; Cernada, María; Cuevas, Isabel de las; Couce, María L.

doi:10.1016/j.anpede.2021.02.006

Cited by 6 publications

(9 citation statements)

References 21 publications

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“…Таким образом, низкая оценка по Апгар указывает на большую тяжесть состояния пациента и ассоциированные с этим худшие исходы. В исследуемои� выборке наблюдаются статистически значимые различия оценки по Апгар на 1-и� и 5-и� минутах между группами: 5 [3][4][5][6][7] и 6 [4][5][6][7] на первои� минуте в 1 и 2 группах соответственно, р < 0,001; 6 [5][6][7][8] и 7 [6][7][8] на 5-и� минуте в 1 и 2 группах соответственно, р < 0,001. Кроме того, в модели логрегресии оценки по Апгар на 1-и� и 5-и� минутах оказались достоверными предикторами потребности в коррекции интенсивнои� терапии при проведении подготовки к транспортировке.…”

Section: Discussionunclassified

“…Применение катехоламинов на этапе подготовки и во время транспортировки не является редкостью [19], при этом потребность в такои� терапии ассоциирована с большим риском осложнении� [20] и риском нетранспортабельности [21]. В исследуемои� выборке наблюдается статистически значимо более частое применение катехоламинов в группе пациентов, нуждавшихся в коррекции параметров интенсивнои� терапии, дофамин 25,90 % [22,[12][13][14][15][16][17][18][19][20][21][22][23][24][25][26][27][28][29]96] и 8,78 % [7,31], первая и вторая группа соответственно, р < 0,001, адреналин 3,78 % [2,29-5,85] и 0,46 % [0,18-0,94], первая и вторая группа соответственно, р < 0,001.…”

Section: Discussionunclassified

“…Следовательно, предтранспортная оценка и подготовка играют существенную роль в формировании исхода и реализации имеющихся рисков [4]. Доступные рекомендации по деятельности не-онатальнои� транспортнои� службы, как правило, сформулированы эмпирически и различаются по содержанию [4][5][6][7]. Вместе с тем важнои� и нерешен-нои� остается задача поиска клинического инструмента, позволяющего определить необходимость в выезде транспортнои� бригады к пациенту и очередность самих выездов.…”

Section: For Citationunclassified

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Predicting the need for intensive care correction during pre-transport stabilization of newborns, requiring medical evacuation

Mukhametshin

Ковтун

Давыдова

et al. 2023

jour

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Introduction. Pre-transport preparation reduces the risks of deterioration when transporting a newborn. Correction of intensive care in the original medical organization may be an indicator of the need for the transport team to travel to the patient. Purpose of the study is to identify predictors of the need for correction of neonatal therapy during pre-transplant preparation. Materials and Methods. Data from all transport team departures of the neonatal intensive care and consultation center between July 1, 2014, and December 31, 2018 (n = 2029) were included in an observational, cohort, retrospective study. Two groups were identified: the first group (n = 502) – patients who underwent correction of intensive care, the second group (n = 1527) – newborns who did not require correction of the ongoing therapy before evacuation. Results. Statistically significant differences in the volume of intensive care administered at baseline medical organization, parameters of respiratory support were observed between patient groups. The oxygenation saturation index demonstrated good predictive properties regarding the need for correction of intensive care with an AUC ROC of 0.696 [0.662–0.730]. Logistic regression revealed the following reliable predictors of the need for therapy correction: Apgar score at 1 and 5 minutes, giving the patient respiratory support, SpO₂/FiO₂ ratio value, catecholamine infusion, and giving therapy in a Level 1 organization. Discussion. The identified predictors indirectly indicate the need for correction of intensive care, which is an argument in favor of an evacuation trip and can be a tool for determining the order of such trips. Conclusion. Predictors of the need to adjust the neonate's therapy include the need for respiratory support (EVI or pCPR), SpO₂/FiO₂ ratio, need for adrenaline or dopamine infusion, Apgar scores at 1 and 5 minutes, and therapy in a Level 1 medical organization.

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Section: Discussionunclassified

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Predicting the need for intensive care correction during pre-transport stabilization of newborns, requiring medical evacuation

Mukhametshin

Ковтун

Давыдова

et al. 2023

jour

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“…9 10 Review of transport team performance in various countries have identified improved outcomes with dedicated neonatal teams, supporting recommendations for specialized teams to be utilized for neonatal transports. 11 12 There is wide variation in how neonatal transport services are organized around the world. Transport services in Scotland, regions of the United Kingdom, Europe, and more recently in North America utilize specialized neonatal transport teams with access to dedicated neonatal transport vehicles.…”

Section: Discussionmentioning

confidence: 99%

Structured Referral Call Handling Process Improves Neonatal Transport Dispatch Times

Mohammad,

Thomas,

Joseph

et al. 2023

Am J Perinatol

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Objective In 2019 the Southern Alberta Neonatal Transport Service adopted a transport call handling process change to expedite transport team mobilization. This study compares the impact of this change on neonatal transport decision to dispatch and mobilization times. Study Design This retrospective cohort study was conducted using a historical cohort of neonates referred for transportation between January 2017 and December 2021. The “dispatch time” (DT) was the time from the start of consultation to the time a decision to dispatch the transport team was made, whereas “mobilization time” (MT) referred to the time from start of consultation to the time the team departed the home base. In 2019, a DT target of <3 minutes was implemented to meet a target MT of <15 and <30 minutes for emergent and urgent high-risk transport referral calls, respectively. In 2021 use of the “Situation” component of the SBAR (Situation, Background, Assessment, Recommendation) communication tool was introduced with the transport team asking five questions to determine need for mobilization. Data between 2017 and 2018 represented the preintervention period, 2019, the “washout” period for implementation, and 2020 to 2021, the postintervention period. Data were analyzed to determine trends in DT and MT. Results The DT was reduced from a median of 5 to 3 minutes following intervention (p < 0.001). DT target goal of 3 minutes was achieved in 67.08% of calls compared with 26.24% in the preintervention period, (p < 0.001). The team achieved MT target goals in 42.71% of urgent and emergent transfers compared with 18.05% prior to intervention (p < 0.001). Conclusion Introduction of a time-sensitive referral call handling process improved dispatch and mobilization time of the neonatal transport team. Key Points

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“…В литературе имеются указания на возможность применения неинвазивной респираторной поддержки в качестве стартового и единственного метода коррекции дыхательных нарушений в учреждениях, не имеющих в своем составе отделений неонатальной реанимации и интенсивной терапии [11][12][13]. Вместе с тем единого мнения относительно возможности, условий и критериев проведения неинвазивной респираторной поддержки новорожденным во время межгоспитальной транспортировки в литературе нет [14,16], а рекомендации носят эмпирический характер [17]. Данное обстоятельство послужило аргументом для проведения настоящего исследования.…”

Section: Introductionunclassified

Noninvasive respiratory support during interhospital transfer of newborns: a retrospective cohort study

Mukhametshin,

Kovtun,

Davydova

et al. 2024

Annals of Critical Care

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INTRODUCTION: Noninvasive respiratory support is a crucial component of neonatal respiratory disorders therapy. The nCPAP (nasal continuous positive airway pressure) is recommended for respiratory support of a premature. There is no consensus on criteria for non-invasive respiratory support for newborns during transfer, the recommendations are empirical. OBJECTIVE: To study the possibility of using nCPAP during pre-transport preparation and transfer of newborns. MATERIALS AND METHODS: The cohort, retrospective study included data on 70 cases of newborns evacuation performed by the transport team (July 1, 2014 — December 31, 2018) to patients who were on nCPAP at the time of the transport team examination in the initial institution. The initial sample was divided into a group of patients transported on ventilation (n = 22) and a group of patients transported on nCPAP (n = 47), respiratory support was discontinued in one case. RESULTS: Statistically significant differences were observed between the FiO2 (34 [30–45] % and 30 [21–30] %, the first and second groups, respectively, p = 0.002) and the saturation index of oxygenation (2.1 [1.6–2.6] and 1.53 [1.3–1.8]) the first and second groups, respectively, p = 0.001). The saturation index of oxygenation has an acceptable predictive value for tracheal intubation during pre-transport preparation (AUC 0.799 [0.682–0.917]). During transfer, one patient of the second group required tracheal intubation (2.1 [0.1–11.3] %). Upon admission, one patient of the second was intubated (2.2 [0.1–11.5] %), no other correction of the parameters of noninvasive support was required for patients of the second group. CONCLUSIONS: The main criterion for intubation at the stage of pre-transport preparation is oxygen requirement during the nCPAP. The saturation oxygenation index (AUC 0.799 [0.682–0.917]) and the SpO2/FiO2 ratio (AUC 0.803 [0.687–0.919]) have an acceptable predictive value for tracheal intubation. The probability of intubation during transportation is 2.1 (0.1–11.3) %.

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Recommendations on the skills profile and standards of the neonatal transport system in Spain

Cited by 6 publications

References 21 publications

Predicting the need for intensive care correction during pre-transport stabilization of newborns, requiring medical evacuation

Predicting the need for intensive care correction during pre-transport stabilization of newborns, requiring medical evacuation

Structured Referral Call Handling Process Improves Neonatal Transport Dispatch Times

Noninvasive respiratory support during interhospital transfer of newborns: a retrospective cohort study

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