Background

Neonatal transport is a risk activity. The sound and vibration environment in the incubator exceed recommended levels, are stressful and effect the infants physiological stability. Furthermore, neonatal transport often implies a separation between the infant and the parents.

Objectives

To compare physiological stability of infants transported by ground ambulance in either Kangaroo Mother Care (KMC) position or positioned in a transport incubator.

Methods

A comparative design of infants transported in KMC position (n=16) versus infants positioned in a transport incubator (n=8). Included infants had a current weight over 1500 g, gestational age above 31+0 weeks, no central catheters, no respiratory support and no planded stressful interventions during the 48 hours follow up period. Physiological stability parameters were defined as heart/respiratory rate, oxygen saturation, body temperature, supplementary oxygen, pain assessment and Transport Risk Index of Physiologic Stability (TRIPS) scores. Time to prepare and restore equipment was estimated.

Results

No differences in physiological stability during transport or the subsequent 48 hours were found. No adverse events were reported. Estimation of time spend to prepare the transport and to restore equipment after the transport was less in the KMC transports

Conclusion

Transportation of infants in KMC position seems as safe as placing the infant in a transport with regard to physiological stability. KMC transports also seems to be more cost-effective compared to use the transport incubator. KMC transports is an option for relatively stable infants. The method also supports family-centred care and decrease the time of separation between the infant and parent.

Background

Red Cross-Vorarlberg and Christophorus Flugrettungsverein, operating the helicopter C8, cover emergency medical transports in Vorarlberg and the surrounding area with a population of 450,000 inhabitants among which are 80,000 children and adolescents.

Objectives

The aim of this thesis is to investigate pediatric emergency medical transports in Vorarlberg-Austria from 2013 to 2017, with its focus placed on patients who suffered trauma.

Methods

Patients from the age of 28 days to 18 years were included.

Results

We report about a total of 2,633 transports, 2,170 on ground and 463 by helicopter, which results in a prevalence of 1:140 children per year. Main age groups were infants (from 1 to 5 years) and schoolchildren (from 6 to 14 years) and 61.4% of them were male, and more than 50% of all transports came from a city or village bigger than 1,000 inhabitants; the main destination was the reference Children’s Hospital Feldkirch with a PICU. The three most common diagnoses were febrile seizures, cerebral concussion and epilepsy.

Transports by helicopter were mostly due to traumatic injuries, amongst which a closed fracture of the lower extremities was the most frequent diagnosis.

The mean mission time with helicopter (43±18.6 minutes) was non-significantly higher compared to the one for ground-based missions (37±19.7 minutes).

Conclusion

This high prevalence of transports of ill children in our study may be due to the highly developed alpine tourism in our region. This result is reflected by the larger amount of trauma patients rescued by the helicopter compared to ground-based transports.