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NICU guideline identifier

Transport - neonatal

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Purpose

This is an overview/operational guideline for the Starship Neonatal Transport Service. The Starship Neonatal Transport team retrieves babies from outlying hospitals and returns babies to their hospital of domicile.

Retrieval - General

  • Retrieval requests/referrals should be directed to the consultant on duty/on call.
  • If a Registrar or NS-ANP receives a referral, it must be discussed with the consultant. During normal working hours, the consultant is either the Level 3 or the Level 2 consultant, depending on the type of referral. Retrieval requests are discussed with the consultant "on call" (4pm - 8.30am) at all other times.
  • The consultant on duty/on call will discuss with the Newborn Clinical Charge Nurse (Mobile 021 874779). The CCN is responsible for organising the transport nurse, the equipment and the mode of transport.
  • For Flight retrievals the nurse will be the Flight Nurse rostered on for the shift. For road retrievals the nurse can either be the flight nurse or any other nurse experienced in ventilated transports.
  • The consultant decides on the medical escort. This will usually be a Neonatal Fellow, one of the Level 3 or Level 2 registrars or an NS-ANP.
  • Out of hours cover of the unit during the transport should be discussed with the on call consultant. RMOs (and NS-ANPs) will not be left with an unsafe workload when providing cross cover for a transport.

Emergency Flight Retrievals

  • The Newborn Service has a rostered dedicated Neonatal Nurse for the Flight Transport Team for emergency flight retrievals. Medical flight team will be determined by the NICU Consultant on duty/oncall.
  • The retrieval process is initiated by a Consultant to Consultant communication
  • The Clinical Charge Nurse is responsible for arranging the flight retrieval in conjunction with Life Flight - 0800 111400.
  • Information required by Life Flight includes Baby name, NHI, diagnosis, name of any accompanying parent and the names of the attending nursing and medical staff.
  • It is the responsibility of the referring service to resuscitate and stabilise the baby until the transport team arrives.
  • We will attempt to respond urgently. The Clinical Charge Nurse will communicate the expected arrival time with the referring hospital.
  • The emergency flight retrieval team will include a doctor/NS-ANP and a flight nurse.
  • It is not possible for the transport team to transfer a newly delivered mother in the same ambulance.
  • It is the responsibility of the referring hospital to arrange her transfer and to contact the Women's Health Duty Manager and arrange for a bed/accommodation for the family.

Emergency Road Retrievals

  • The retrieval process is initiated by consultant to consultant communication
  • The Clinical Charge Nurse is responsible for arranging the transport.
  • The receiving consultant will arrange the medical team; the Clinical Charge Nurse will arrange the transport nurse.
  • The transport nurse can either be the Flight Nurse on call for the shift or any other nurse who is experienced in ventilated transports.
  • It is not possible for the transport team to transfer a newly delivered mother in the same ambulance.
  • It is the responsibility of the referring hospital to arrange her transfer and to contact the Women's Health Duty Manager and arrange for a bed/accommodation for the family.

Referrals from North Shore, Waitakere and Middlemore Hospitals (road transport)

  • Babies from these hospitals will have been assessed by a paediatrician prior to referral.
  • Sick or unstable babies will be retrieved by the NICU Transport Team.
  • Stable babies may be transferred by the referring team if collectively agreed.

Referrals from Birthcare

Birthcare does not have a resident paediatric physician.

Unstable/critical babies

  • Birthcare will call for a 111 Ambulance and arrange an acute neonatal transfer to Starship Hospital CED.
  • CED will contact the NICU team who will attend CED to triage baby.

Stable baby/level 2 admission

  • Birthcare will discuss with the level 2 Neonatologist, who will determine whether the neonatal transport team will attend or whether an ambulance transfer by Birthcare team should take place.

Back Transfers

  • Back transfers to other hospitals are usually elective.
  • They are arranged by The Clinical Charge Nurse in consultation with the Level 2 or Level 3 medical team

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Document Control

  • Date last published: 30 July 2015
  • Document type: Clinical Guideline
  • Services responsible: Neonatology
  • Owner: Newborn Services Clinical Practice Committee
  • Editor: Sarah Bellhouse
  • Review frequency: 2 years