Neonatal Land Transport

Abstract

Improved perinatal care over the past decades (prenatal diagnosis and good timing of the prenatal transport) has resulted in the fact that seriously ill newborns are born in larger perinatal centers (with level III of perinatal care). In these centers newborns are provided with high level of care and treatment. When this is not the case, the newborn prognosis is largely affected by the level of perinatal care. Due to the lack of needed treatment, they have to be transferred to the higher level of perinatal care. The sooner the problem is identified, the better is the neonatal outcome. However, the postnatal transport is tied with the higher morbidity and mortality than the prenatal transport (transport in utero), particularly with the extremely immature and very immature neonates. In order to achieve proper medical transport for these high-risk and vulnerable neonates, there is a need for highly skilled staff and sophisticated medical equipment. In an ideal world neonatal transport team is one of the important factors in neonatal care. This procedure is followed by treatment in the neonatal intensive care unit (NICU) where the personnel and the equipment are dedicated to these babies. By the type of transport (land, air, water), and organization (one way, two way) and a different personnel in the transport team, neonatal transport is organized differently in various countries. It is extremely important to have highly educated, knowledgeable and well equipped transport service providers. The need for stabilizing the patient prior the transport is essential. Moreover, all the necessary medical and technical procedures are to be performed before and during transport (regardless of the participants in the transport team). Special procedures (surfactant replacement therapy, "cooling", prostaglandin treatment etc.) should be applied by an experienced team that has the knowledge and skills in these techniques, as well as in monitoring of the patient and possible complications. There are some special procedures in the neonatal transport of surgical patients like stomach emptying before the transport, ventilation, prone or supine positioning etc.