The interfacility transport of critically ill newborns

Abstract

The practice of paediatric/neonatal interfacility transport continues to expand. Transport teams have evolved into mobile intensive care units capable of delivering state-of-the-art critical care during paediatric and neonatal transport. While outcomes are best for high-risk infants born in a tertiary care setting, high-risk mothers often cannot be safely transferred. Their newborns may then have to be transported to a higher level of care following birth. The present statement reviews issues relating to transport of the critically ill newborn population, including personnel, team competencies, skills, equipment, systems and processes. Six recommendations for improving interfacility transport of critically ill newborns are highlighted, emphasizing the importance of regionalized care for newborns.

The Transport and Outcome of Sick Outborn Neonates Admitted to a Regional and District Hospital in the Upper West Region of Ghana: A Cross-Sectional Study

“…However it is worse than a study of 73 babies in Cameron which reported hypothermia among 20% and a study of 150 neonates in Bangladesh, which reported 14% [9,32]. While hypothermia may be associated with medical conditions such as prematurity and inadequate stabilisation of these babies before transfer, it might have been aggravated by long travel distances to reach the destination hospitals, the mode of transportation and the form of thermal protection (e.g., wrapping or kangaroo mother care used during the journey) [20,26,27,29,30,33]. Our patients might have been affected by some of these factors.…”

“…Our findings may be a reflection of the low level of resources available in this region. Travelling by ambulance usually provides a source of oxygen, equipment for resuscitating newborns, drugs and other supplies to stabilise the infant during travel [28,33,44].…”

Neonatal Transport in the Practice of the Crews of the Polish Medical Air Rescue: A Retrospective Analysis

“…It also meets the relevant technical and quality standards compliant with national and European standards [10]. However, if a newborn is transported over a distance exceeding 100 km, the transportation should be provided by air transport teams [10,13]. In Poland, neonatal transports of premature infants and full-term newborns weighing not more than 5000 g are carried out by Medical Air Rescue crews [10,12].…”

Diagnosis Discordance and Neonatal Transport: A Single-Center Retrospective Chart Review

“…Access to a higher level of care is facilitated by specialized neonatal transport teams and tertiary level physicians, who provide timely clinical advice, support, and transfer from one facility to another. 1 Appropriate recognition and stabilization of an acutely ill infant prior to transport is paramount to optimize patient outcomes and reduce adverse outcomes. 2 The process of transporting an acutely ill newborn is initiated when the referring health care provider contacts the regional tertiary level referral center and transport team.…”