Key issues in transportation

Hello friends, in this webinar, we shall discuss some key issues in transportation of a sick neonate
The best mode of transport of a preterm neonate is in-utero transport before delivery to a higher center To have a smooth transfer of sick babies we need to have optimal resources in terms of human resources, equipment and vehicle. We also need to ensure optimal Pre transport stabilization of baby, Communication, and Documentation
The Human resources for the transportation could include depending on the availability; the doctors or nurses And it could be ANMs or ASHA workers if transport is being done from a remote area. An ambulance with minimal life saving equipment with such as oxygen, ventilator, power back up and infusion pumps and essential drugs should be available
There are various models available for pre-transport stabilization and care during transport. The emphasis on pre tansport stabilization includes optimizing temperature, airway, breathing, circulation, blood sugar and ensuring emotional support to parents. Some of the popular acronyms are as shown in the slide and include STABLE and TOPS: [ STABLE: which stands for Sugar, Temperature, Artificial breathing, Blood pressure, Laboratory work, and Emotional support. TOPS: stands for Temperature, Oxygenation (Airway & Breathing), Perfusion, and Sugar]
It is important to have regular and effective communication between the referring unit and the referred hospital about the underlying condition, diagnosis, treatment given and reason for transfer of baby. The parents should be informed about the reasons for transfer. Effective communication is the key to reduce the medico-legal complications that arise during transportation. It is also important for the referred unit to give feedback on the condition of the baby transferred to parent unit. Finally, all these need to be documented and should include appropriate consent forms, lab reports and data sheets.
During transport we need to ensure that the Temperature, Airway, Breathing and Circulation of the baby is maintained. It is best not to attempt feeding sick babies with abnormal sensorium or severe respiratory distress before or during transfer and maintain them on IV fluids. It is important to take the baby to the nearest health facility by the fastest mode of transport by the shortest route.
  • Introduction...
  • 1. Transport of si...
  • 2. Resources...
  • 3. Pre transport s...
  • 4. Communication a...
  • 5. Care during tra...
 

Introduction

DR. COL K. VENKATNARAYAN
MD, DNB, MNAMS, DM (Neonatology)

Head & Associate Professor
Command Hospital
Pune

1. Transport of sick neonate

â–º Best transport of preterm baby is in-utero transfer before
    delivery

â–º For ideal transport, ensure optimal
      ♦ Resources: personnel, equipment, vehicle
      ♦ Pre transport stabilization of baby
      ♦ Communication
      ♦ Documentation

2. Resources

â–º Human resources
      ♦ Doctors, nurses, ANM, ASHA worker

â–º Ambulance and equipments
      ♦ Oxygen, ventilator, power back up and infusion pumps
        and essential drugs should be available

3. Pre transport stabilization

4. Communication and documentation

â–º Effective communication
      ♦ Between referring and referred units, parents, doctors,
        feedback

â–º Documentation
      ♦ History, treatment given, diagnosis, reasons for transfer,
        consents

5. Care during transport

â–º Ensure Temperature, Airway, Breathing and Circulation

â–º It is best to not attempt feeding sick babies with
    abnormal sensorium or severe respiratory distress before
    or during transfer

â–º Take baby to nearest facility by fastest mode of transport by
    the shortest route