Transports of Sick Neonates to a Tertiary Care Hospital: Condition at Arrival and Outcomes

• Published in: Journal of neonatology 2019-03, Vol.33 (1-4), p.10-12
• Main Authors: Chandrashekhar, Channanayaka, Doreswamy, Srinivasa Murthy, Nataraj, Nanda, Panachiyil, George Mathew, Babu, Tirin
• Format: Article
• Language: English
• ISSN: 0973-2179; 0973-2187
• DOI: 10.1177/0973217919896210

Abstract Objective: To evaluate the transport system, condition of the baby on arrival, and the outcome of the sick neonates transported to our hospital. Methodology: This prospective study included 100 neonates referred to our hospital. A pro forma with a questionnaire regarding the transport details was filled with information taken from the parents/attendant accompanying the baby. Results: A total of 100 number of referrals over a period of 8 months were included. Almost half the referrals were in the first week of life: 74% were term and 26% preterm. Only 28% of the babies were sent with prior communication to our hospital. About 69% babies had a referral document of them, but only 26% had complete information regarding the baby’s illness and prior treatment. The modes of transport used were private ambulance (36%), car (25%), and government ambulance (22%). Few newborns were brought by autorickshaw (12%), bus (3%), and two-wheeler (2%) too. None of the babies were brought with kangaroo mother care (KMC) during transit. Intratransport care included supplemental oxygen (53%) and IV medications (14%). On arrival the transported neonates had problems such as prolonged capillary filling time (78%), hypothermia (72%), respiratory distress (23%), hypoglycemia (14%), needing life support (14%), and apnea (8%). Out of them, 85% improved, 12% were discharged against medical advice, 2% died, and 1% referred. Conclusion: The study highlights the unaddressed challenges and the scope for improving the transport of sick neonates between hospitals and further emphasizes the need for devising solutions.