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Veldman A, Krummer S, Schwabe D, Diefenbach M, Fischer D, Schmitt-Kästner S, Rohrbeck C, Pannu R. Safety and Feasibility of Long-Distance Aeromedical Transport of Neonates and Children in Fixed-Wing Air Ambulance. J Pediatr Intensive Care 2023; 12:235-242. [PMID: 37565016 PMCID: PMC10411161 DOI: 10.1055/s-0041-1731681] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2021] [Accepted: 05/27/2021] [Indexed: 08/12/2023] Open
Abstract
In cases of critical injury or illness abroad, fixed-wing air ambulance aircraft is employed to repatriate children to their home country. Air ambulance aircraft also transport children to foreign countries for treatment not locally available and newborns back home that have been born prematurely abroad. In this retrospective observational study, we investigated demographics, feasibility, and safety and outcomes of long-distance and international aeromedical transport of neonates and children. The study included 167 pediatric patients, 56 of those preterm neonates. A total of 41 patients were ventilated, 45 requiring oxygen prior to the transport, 57 transferred from an intensive care unit (ICU), and 48 to an ICU. Patients were transported by using Learjet 31A, Learjet 45, Learjet 55, and Bombardier Challenger 604, with a median transport distance of 1,008 nautical miles (NM), median transport time of 04:45 hours (median flight time = 03:00 hours), flight time ≥8 hours in 15 flights, and transport time ≥8 hours in 29 missions. All transports were accompanied by a pediatric physician/nurse team. An increase in FiO 2 during the transport was documented in 47/167 patients (28%). Therapy escalation (other than increased oxygen) was reported in 18 patients, and technical adverse events in 3 patients. No patient required CPR or died during the transport. Clinical transport outcome was rated by the accompanying physician as unchanged in 163 transports, improved in 4, and deteriorated in none. In summary, international, long-distance transport of neonatal and pediatric patients performed by experienced and well-equipped transport teams is feasible. Neither major adverse events nor physician-rated clinical deteriorations were observed in this group of patients.
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Affiliation(s)
- Alex Veldman
- Jetcall Air Ambulance, Idstein, Germany
- Department of Pediatrics, St. Vincenz Hospital, Limburg, Germany
- The Ritchie Centre, Hudson Institute of Medical Research, Monash University, Melbourne, Australia
| | - Stefanie Krummer
- Jetcall Air Ambulance, Idstein, Germany
- Department of Pediatrics, St. Vincenz Hospital, Limburg, Germany
| | | | | | - Doris Fischer
- Jetcall Air Ambulance, Idstein, Germany
- Department of Pediatrics, St. Vincenz Hospital, Limburg, Germany
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Tankala R, Huang L, Hiskens M, Vangaveti V, Kandasamy Y, Hariharan G. Neonatal retrievals from a regional centre: Outcomes, missed opportunities and barriers to back transfer. J Paediatr Child Health 2023; 59:680-685. [PMID: 36799108 DOI: 10.1111/jpc.16370] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2022] [Revised: 01/11/2023] [Accepted: 01/29/2023] [Indexed: 02/18/2023]
Abstract
AIM High-risk neonates are retrieved from regional centres to tertiary neonatal units when the required care of the baby exceeds the clinical capabilities of the birthing facility. However, there is limited research on the outcomes of neonatal retrievals from regional special care centres and the barriers to back transfer of neonates from a tertiary centre are not well established. This study aimed to review the outcome of neonatal retrievals >32 weeks gestation from a regional referral centre. The study also aimed to determine missed opportunities for providing care at the regional centre and evaluate patient back transfer delays. METHODS All neonates transferred to a tertiary neonatal intensive care unit in North Queensland over the 5-year period January 2016 to December 2020 from a regional neonatal centre were retrospectively reviewed from the electronic medical records. RESULTS Fifty neonates transferred to a tertiary neonatal intensive care unit over the study period were identified. Between 2016 and 2020, the number of neonatal retrievals increased (P = 0.021). Out of the 50 neonatal retrievals, 86% were for medical reasons. Overall, eight neonates were identified as missed opportunities whose care could have been maintained at the regional centre with support from the tertiary neonatal intensive care unit. In total, 16 neonates were affected by a delay in back transfer. CONCLUSIONS This study shows a significant increase in retrievals to tertiary neonatal intensive care unit over the study period. Increasing bed capacity, utilising telehealth and recruiting regional special care nursery staff could improve outcomes and reduce strain on tertiary neonatal resources.
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Affiliation(s)
- Ravi Tankala
- Department of Paediatrics, Mackay Base Hospital, Mackay, Queensland, Australia
| | - Lee Huang
- Department of Paediatrics, Mackay Base Hospital, Mackay, Queensland, Australia
| | - Matthew Hiskens
- Mackay Institute of Research and Innovation, Mackay Base Hospital, Mackay, Queensland, Australia
| | - Venkat Vangaveti
- School of Medicine and Dentistry, James Cook University, Townsville, Queensland, Australia
| | - Yoga Kandasamy
- Neonatal Unit, The Townsville University Hospital, Townsville, Queensland, Australia
| | - Gopakumar Hariharan
- Department of Paediatrics, Mackay Base Hospital, Mackay, Queensland, Australia.,School of Medicine and Dentistry, James Cook University, Townsville, Queensland, Australia
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Capriolo C, Viscardi RM, Broderick KA, Nassebeh S, Kochan M, Solanki NS, Leung JC. Assessment of Neonatal Intensive Care Unit Sound Exposure Using a Smartphone Application. Am J Perinatol 2022; 39:189-194. [PMID: 32702769 DOI: 10.1055/s-0040-1714679] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
OBJECTIVE This study aimed to determine the impact of neonatal intensive care unit (NICU) design and environmental factors on neonatal sound exposures. We hypothesized that monitoring with a smartphone application would identify modifiable environmental factors in different NICU design formats. STUDY DESIGN Minimum, maximum, and peak decibel (dB) recordings were obtained using the Decibel X phone app, and the presence of noise sources was recorded in each patient space at three NICUs over a 6-month period (December 2017 to May 2018). Data were analyzed by Student's t-test and ANOVA with Bonferroni correction. Data were collected at the University of Maryland Medical Center single family room (SFR) level IV and St. Agnes Healthcare hybrid pod/single family room level III NICU, Baltimore, MD and at Prince George's Hospital Center open-pod design Level III NICU, Cheverly, MD. RESULTS All recordings in the three NICUs exceeded the American Academy of Pediatrics (AAP) recommended <45 dB level. The maximum and peak dB were highest in the open pod format level III NICU. Conversations/music alone and combined with other factors contributed to increased sound exposure. Sound exposure varied by day/night shift, with higher day exposures at the level III hybrid and open pod NICUs and higher night exposures at the level IV SFR NICU. CONCLUSION Although sound exposure varied by NICU design, all recordings exceeded the AAP recommendation due, in part, to potentially modifiable environmental factors. A smartphone application may be useful for auditing NICU sound exposure in quality improvements efforts to minimize environmental sound exposure. KEY POINTS · Smartphone application was used to assess NICU sound exposure.. · All cases of sound exposure exceed recommendations.. · A smartphone application was used to identify modifiable factors..
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Affiliation(s)
- Christine Capriolo
- Department of Pediatrics, University of Maryland School of Medicine, Baltimore, Maryland
| | - Rose M Viscardi
- Department of Pediatrics, University of Maryland School of Medicine, Baltimore, Maryland
| | | | - Sepideh Nassebeh
- Department of Pediatrics, St. Agnes Hospital, Baltimore, Maryland
| | - Michael Kochan
- Department of Pediatrics, University of Maryland School of Medicine, Baltimore, Maryland
| | - Nina S Solanki
- Department of Pediatrics, Jersey Shore University Medical Center Neptune City, Neptune City, New Jersey
| | - Jocelyn C Leung
- Department of Pediatrics, University of Maryland School of Medicine, Baltimore, Maryland
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Fanti G, Borghi F, Spinazzè A, Rovelli S, Campagnolo D, Keller M, Cattaneo A, Cauda E, Cavallo DM. Features and Practicability of the Next-Generation Sensors and Monitors for Exposure Assessment to Airborne Pollutants: A Systematic Review. SENSORS (BASEL, SWITZERLAND) 2021; 21:4513. [PMID: 34209443 PMCID: PMC8271362 DOI: 10.3390/s21134513] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/24/2021] [Revised: 06/25/2021] [Accepted: 06/28/2021] [Indexed: 11/22/2022]
Abstract
In the last years, the issue of exposure assessment of airborne pollutants has been on the rise, both in the environmental and occupational fields. Increasingly severe national and international air quality standards, indoor air guidance values, and exposure limit values have been developed to protect the health of the general population and workers; this issue required a significant and continuous improvement in monitoring technologies to allow the execution of proper exposure assessment studies. One of the most interesting aspects in this field is the development of the "next-generation" of airborne pollutants monitors and sensors (NGMS). The principal aim of this review is to analyze and characterize the state of the art and of NGMS and their practical applications in exposure assessment studies. A systematic review of the literature was performed analyzing outcomes from three different databases (Scopus, PubMed, Isi Web of Knowledge); a total of 67 scientific papers were analyzed. The reviewing process was conducting systematically with the aim to extrapolate information about the specifications, technologies, and applicability of NGMSs in both environmental and occupational exposure assessment. The principal results of this review show that the use of NGMSs is becoming increasingly common in the scientific community for both environmental and occupational exposure assessment. The available studies outlined that NGMSs cannot be used as reference instrumentation in air monitoring for regulatory purposes, but at the same time, they can be easily adapted to more specific applications, improving exposure assessment studies in terms of spatiotemporal resolution, wearability, and adaptability to different types of projects and applications. Nevertheless, improvements needed to further enhance NGMSs performances and allow their wider use in the field of exposure assessment are also discussed.
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Affiliation(s)
- Giacomo Fanti
- Department of Science and High Technology, University of Insubria, 22100 Como, Italy; (A.S.); (S.R.); (D.C.); (M.K.); (A.C.); (D.M.C.)
| | - Francesca Borghi
- Department of Science and High Technology, University of Insubria, 22100 Como, Italy; (A.S.); (S.R.); (D.C.); (M.K.); (A.C.); (D.M.C.)
| | - Andrea Spinazzè
- Department of Science and High Technology, University of Insubria, 22100 Como, Italy; (A.S.); (S.R.); (D.C.); (M.K.); (A.C.); (D.M.C.)
| | - Sabrina Rovelli
- Department of Science and High Technology, University of Insubria, 22100 Como, Italy; (A.S.); (S.R.); (D.C.); (M.K.); (A.C.); (D.M.C.)
| | - Davide Campagnolo
- Department of Science and High Technology, University of Insubria, 22100 Como, Italy; (A.S.); (S.R.); (D.C.); (M.K.); (A.C.); (D.M.C.)
| | - Marta Keller
- Department of Science and High Technology, University of Insubria, 22100 Como, Italy; (A.S.); (S.R.); (D.C.); (M.K.); (A.C.); (D.M.C.)
| | - Andrea Cattaneo
- Department of Science and High Technology, University of Insubria, 22100 Como, Italy; (A.S.); (S.R.); (D.C.); (M.K.); (A.C.); (D.M.C.)
| | - Emanuele Cauda
- Center for Direct Reading and Sensor Technologies, National Institute for Occupational Safety and Health, Pittsburgh, PA 15236, USA;
- Centers for Disease Control and Prevention, Pittsburgh, PA 15236, USA
| | - Domenico Maria Cavallo
- Department of Science and High Technology, University of Insubria, 22100 Como, Italy; (A.S.); (S.R.); (D.C.); (M.K.); (A.C.); (D.M.C.)
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Jordán Lucas R, Boix H, Sánchez García L, Cernada M, Cuevas IDL, Couce ML. Recommendations on the skills profile and standards of the neonatal transport system in Spain. An Pediatr (Barc) 2021; 94:420.e1-420.e11. [PMID: 34049845 DOI: 10.1016/j.anpede.2021.02.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2020] [Accepted: 02/08/2021] [Indexed: 11/16/2022] Open
Abstract
The first hours of life of a sick or premature newborn are crucial for its prognosis and therefore delivery should take place in a center prepared for that degree of complexity. When this condition is not met, the newborn must be transferred in an optimal and safe way to the center that can offer the necessary care. The training, staffing, organization and coordination of the neonatal transport team are essential to guarantee a safe transfer. Being aware of the interest and the advances that are currently taking place in this area of pediatrics, the Standards Commission and the Neonatal Transport Commission of the Spanish Society of Neonatology have prepared this document. In it, both the provision of human and material resources necessary as well as the bases of clinical stabilization in transport to carry out the neonatal transfer in a safe way and proportionate to the needs of the critical newborn have been exhaustively reviewed and detailed.
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Affiliation(s)
- Raquel Jordán Lucas
- Servicio de Neonatología, Hospital Universitari Vall d'Hebron, Comisión de Transporte Neonatal, Barcelona, Spain.
| | - Hector Boix
- Servicio de Neonatología, Hospital Universitari Vall d'Hebron, Comisión de Estándares, Barcelona, Spain
| | - Laura Sánchez García
- Servicio de Neonatología, Hospital Universitario La Paz, Comisión de Transporte Neonatal, Madrid, Spain
| | - María Cernada
- Servicio de Neonatología, Hospital Universitario y Politécnico La Fe, Grupo de Investigación en Perinatología, Instituto de Investigación Sanitaria La Fe, Comisión de Estándares, Valencia, Spain
| | - Isabel de Las Cuevas
- Hospital Universitario Marqués de Valdecilla, Departamento de Ciencias Médicas y Quirúrgicas Universidad de Cantabria, Comisión de Transporte Neonatal, Santander, Spain
| | - Maria L Couce
- Servicio de Neonatología, Hospital Clínico Universitario de Santiago, IDIS, Universidad de Santiago de Compostela, Comisión de Estándares, Santiago de Compostela, Spain
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Jordán Lucas R, Boix H, Sánchez García L, Cernada M, de Las Cuevas I, Couce ML. [Recommendations on the skills profile and standards of the neonatal transport system in Spain]. An Pediatr (Barc) 2021. [PMID: 33771458 DOI: 10.1016/j.anpedi.2021.02.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
Abstract
The first hours of life of a sick or premature newborn are crucial for its prognosis and therefore delivery should take place in a center prepared for that degree of complexity. When this condition is not met, the newborn must be transferred in an optimal and safe way to the center that can offer the necessary care. The training, staffing, organization and coordination of the neonatal transport team are essential to guarantee a safe transfer. Being aware of the interest and the advances that are currently taking place in this area of pediatrics, the Standards Commission and the Neonatal Transport Commission of the Spanish Society of Neonatology have prepared this document. In it, both the provision of human and material resources necessary as well as the bases of clinical stabilization in transport to carry out the neonatal transfer in a safe way and proportionate to the needs of the critical newborn have been exhaustively reviewed and detailed.
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Affiliation(s)
- Raquel Jordán Lucas
- Servicio de Neonatología, Hospital Universitari Vall d'Hebron, Barcelona, España. Comisión de Transporte Neonatal.
| | - Hector Boix
- Servicio de Neonatología, Hospital Universitari Vall d'Hebron, Barcelona, España. Comisión de Estándares
| | - Laura Sánchez García
- Servicio de Neonatología, Hospital Universitario La Paz, Madrid, España. Comisión de Transporte Neonatal
| | - María Cernada
- Servicio de Neonatología, Hospital Universitario y Politécnico La Fe, Grupo de Investigación en Perinatología, Instituto de Investigación Sanitaria La Fe, Valencia, España. Comisión de Estándares
| | - Isabel de Las Cuevas
- Unidad Neonatal, Servicio de Pediatría, Hospital Universitario Marqués de Valdecilla, Departamento de Ciencias Médicas y Quirúrgicas Universidad de Cantabria, Santander, España. Comisión de Transporte Neonatal
| | - María L Couce
- Servicio de Neonatología, Hospital Clínico Universitario de Santiago, IDIS, Universidad de Santiago de Compostela, Santiago de Compostela, España. Comisión de Estándares
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