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WMNTS Transport User Group Meeting

WMNTS Transport User Group Meeting. Monday 21 st October 2013. Referrals April – Sept 2013. Trend with Time. Accepted Transfers April- Sept 2013. Types of Transfer. Categories of Transfer. Level of Transfer. Timing. Categories of Transfer. Cooling. Incidents. Time critical transfers.

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WMNTS Transport User Group Meeting

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  1. WMNTS Transport User Group Meeting Monday 21st October 2013

  2. Referrals April – Sept 2013

  3. Trend with Time

  4. Accepted Transfers April- Sept 2013

  5. Types of Transfer

  6. Categories of Transfer

  7. Level of Transfer

  8. Timing

  9. Categories of Transfer

  10. Cooling

  11. Incidents

  12. Time critical transfers • 100% SSBCNN (6) • 71% SWMNN (2 – both on call)

  13. Clinical case

  14. Twin II • Referral at 21:30 • Mobilisation 21:45 • Arrival 22:15 • Decision made to move twin II 1st as more stable • 18/6 x 0.33 x 50 – 99% saturated • Awaiting xray(done 23:00) • Temp 33.5 – incubator temp & transwarmer • UAC not tracing; cuff bp 21-24 (bolus given)

  15. Twin II • Xrays reviewed • ET (6.5cm) @ T5 withdrawn 0.5cm – to 6cm • UAC (T10) withdrawn to L3-4 (2.5cm) • UVC – at diaphragm

  16. Twin II • Repeat gas – no changes • Temp 36.2 @23:30 • Dopamine & dobutamine commenced at 10/10 – mean bp >25 subsequently (00:00) • Temp 37.5 @ 24:00 • Repeat gas – no changes • Transferred into WMNTS incubator

  17. Twin II • ET noted at 4cm - ? Dislodged; weak response pedicap • Reintubated in transport incubator – fixed at 6 cm; repeat dislodged ET- reintubated • Repeat xray ET T3 • Repeat ABG – pCO2 3.5 – PIP and I time decreased • Transferred on 20/5x 50 x24%

  18. Twin II • Uneventful transfer • Incident generated for hypothermia

  19. Twin I • Arrived referring unit 04:05 • 21/5 x 60 x 78% - sats 96% • Dobutamine & dopamine – BP maintained • ABG pH 7.16, pCO2 8.89 • Unable to deliver HFO in transfer • 2ndcurosurf & PIP @23

  20. Twin I • Transferred into incubator • Hypertensive – inotropes stopped • Repeat ABG – pCO2 7.5 • Uneventful transfer to New Cross • Arrived @ 06:50

  21. Staffing • Continue to have Deanery trainee • 1x ANNP post filled with clinical fellow • 1x ANNP rotational post • 1 nurse rotation • 1 nurse secondment • 2 student ANNPs • 2 nurse vacancies • SSBCNN consultant post filled

  22. Rota • Resident 4 nights of week (mon-thurs)

  23. New Equipment • Techotherm in use • 2 Inditherm mattresses bought • Glucometer in response to clinical incidents • New ambulances

  24. Education • Cooling study day • WMNTS training day Dec 13 • Staff involved in MSc Advanced Practice programme & Undergraduate education • Staff involved in MLU education programme • 1x GIC completed

  25. Future developments • Cot locator seconded to KIDS for 6 months to support NVSN • Working with commissioners, QIP etc to achieve NIC transport specifications (gap analysis – teleconferencing & dedicated 24/7 consultant support)

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