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Neonatal Transfer by road David Bresler METRO

Neonatal Transfer by road David Bresler METRO. Objectives. What is a neonate? Highlight the logistics required for safe transportation of the neonate. The checks done preparing for transportation. Which type of illnesses are commonly transferred (high risk) The receiving hospital.

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Neonatal Transfer by road David Bresler METRO

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  1. Neonatal Transfer by roadDavid BreslerMETRO

  2. Objectives What is a neonate? Highlight the logistics required for safe transportation of the neonate. The checks done preparing for transportation. Which type of illnesses are commonly transferred (high risk) The receiving hospital

  3. What is a neonate? Neonate - 1st 28 days, full term 38-40wks Premature Neonate - < 38 wks / < 2,5kgs Post term – born after 42wks

  4. Neonates vitals Pulse Rate 80 – 160 (acceptable) Haemoglobin 17 g/dl Respiration 30 – 80 Posture flexed Sight can distinguish light & dark Hearing well established at birth

  5. The medium of travel Lets state the obvious… Code 10 drivers licence. Competent personnel. Enough petrol. Roadworthy vehicle.

  6. Equipment Adequate, functioning equipment (suction, ECG with additional batteries and paper, charging or charged dinamap) Enough 02 for the journey. A working heater (cold weather)

  7. Equipment Syringe driver for specific drug dosage administration. Ventilator with serviced connections and tubing. Telethermometer.

  8. Equipment Whenever using ventilator, ALWAYS have a BVMR in incubator, connected to a separate, closed, small 02 cylinder, in case of ventilator malfunction.

  9. The incubator Transportable. Light weight. Must be able to be battery supported. Must have accessible portholes. Must fit onto ambulance stretcher.

  10. Incubator Must have power access to ambulance. While out of ambulance, incubator should have either charged-up extended battery life, or back-up portable battery support system.

  11. Preparation Pre-warm neonatal mattress on the way to transferring hospital, by inverting mattress onto base of incubator, and then place it …

  12. “right way around” on scene. When infant is placed into “bed”, it will be nicely warmed up. Preparation

  13. Preparation Remember to pre-clean incubator with soap and warm water, and then disinfectant solution, before and after conveying infant.

  14. Preparing for transport Vitals: Respiratory rate Check setting on ventilator, and set babylog accordingly. NB: Always keep a close eye on babies clinical picture and vitals.

  15. Preparing for transport Easy formula to set ventilator if no parameters to work on: ( 60 seconds / respiratory rate / I+E = Inspiratory time) If I:E is 1:1 divide by 2, if I:E 1:2, divide by 3, etc. Once you have inspiratory time, work out expiratory time, based on ratio. Flow/ sec = Tidal volume / Inspiratory time. On ventipac : Inspiratory + expiratory times + flow/ litres per sec = minute volume.

  16. Preparing for transport Blood pressure ( gestational age of prem baby same as M.A.P. on Dinamap) Temp 36,5 C Heart rate 120-160 normal HGT 3,5 mmol/l min. Remember to dilute to 12,5 % if low. (For every 1 ml of 50% Dextrose / kg, dilute with 3mls sterile water or 0.9 % sodium chloride.

  17. Prepare for transport Check ID, compare with mothers folder. IV fluids ( Neonatalyte) History Reason for transfer Escorts?

  18. High risk neonate Hypoxia Hypoglycaemia Hypothermia Hyperbilirumenaemia

  19. High risk neonate Hypovolaemia Heavy sedation Infection

  20. Receiving hospital Ensure receiving hospital is aware of patients condition. Receiving Doctors name.

  21. SUMMARY What is a neonate? Highlight the logistics required for safe transportation of the neonate. The checks done preparing for transportation. Which type of illnesses are commonly transferred (high risk) The receiving hospital

  22. Questions End

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