Specialised neonatal transport

Newborn transport is used to move premature and other sick infants from hospitals without specialist, intensive care facilities require for optimal care of the baby to hospitals with neonatal intensive care and other specialist services. Neonatal transport services such as NETS use mobile intensive care incubators fitted with mechanical ventilators, infusion pumps and physiological monitors capable of being used in a mobile environment. These transport systems seek to emulate the environment of a neonatal intensive care and permit un-interrupted care to occur in a referring hospital and then during the journey by road or air ambulance. Power and medical gas supplies are carried within the system as well as making use of external supplies; as available. Infant transport systems commonly weigh over 100 kg and present a challenge to vehicle operators in terms of weight, manual handling, crashworthiness and power consumption.

It is important to secure the neonate inside the incubator. A rearward facing seat with a 5-point body harness has been used in adults which is inappropriate for a premature neonate with respiratory failure. Placing a belt over the top of a neonatal patient will provide some protection if the ambulance drops vertically, but provides virtually no protection to a supine or prone patient in the event of a head-on collision. Neonatal harnesses are now commercially available (Neo-restraint, Paraid Medical) which consists of a series of foam wedges and straps, than can be adjusted to the position and size of the infant within the transport incubator.

Principals of transport remain same for any type of transport.43 Pre-transport stabilization: Available models for pre-transport stabilization and care during transport are:

• STABLE: Sugar, Temperature, Artificial breathing, Blood pressure, Laboratory work, Emotional support.

37 • SAFER: Sugar, Arterial circulatory support, Family support, Environment, Respiratory support.

38 • TOPS: Temperature, Oxygenation (Airway & Breathing), Perfusion, Sugar