Sometimes it is necessary to transfer an expectant mother who is experiencing a high risk pregnancy from one hospital to another hospital before the birth of her infant. This is referred to as an in-utero transfer and ensures that when the infant is born, he/she is delivered at a location where the infant can receive the care and expertise of a medical team that are best equipped to offer the infant the optimum care.
Infants who require additional medical or surgical also may require transfer from one hospital to another. Very preterm infants born in smaller units will be transferred to a larger neonatal unit in order to obtain a more comprehensive range of intensive care. The transfer of a very preterm or ill infant is a complex procedure requiring planning, organization and skilled staff.
The National Neonatal Transport Programme (NNTP) www.nntp.ie is responsible for the transport of these infants in Ireland. The programme accepts calls for transfer twenty fours a day, seven days a week, via a dedicated NNTP Transport Hotline’ Number . This number connects automatically to the relevant hospital on-call for transport each week. A designated neonatal transport nurse, neonatal registrar and an ambulance driver are available to set out within 40 minutes to any hospital for a sick infant. The team travel in one of the NNTP’s dedicated ambulances, which has been designed and equipped especially for neonatal retrievals.
When air transport is required, the NNTP’s air transport module is utilised in the Irish Air Corps’ helicopters/fixed wing aircraft . The team provides stabilisation advice and intensive care at the referring hospital, prior to, as well as during the transport to the relevant tertiary centre. The NNTP conducts one transport at a time, except in the case of twins when if necesary, both infants can be accommodated together in the road ambulance. If two or more transport requests are received simultaneously, priority is given to the most critically ill baby and/or the baby in a hospital with limited personnel/resources to provide care for extended periods of time. Guidelines and protocols are available in all neonatal units in Ireland.
Modes of transport utilized by NNTP
- Road ambulance
- Rotary wing (helicopter)
- The majority of NNTP transfers are by road as this is usually the most practical mode of transport in Ireland.
- The NNTP has two custom fitted ambulances and a back up vehicle dedicated to the service.
The NNTP Ambulance is equipped with:
- Complete transport incubator system including: Ventilator (SIMV/CPAP), suction, vital signs monitor, syringe pumps
- Nitric Oxide delivery system
- Portable Blood Gas Analysis system
- Locking device and tracking to secure incubators
- Forward style seating
- Hydraulic lift for incubator
- Generator to provide AC power
- O2 and Air supply >10 hrs
- Capacity to transport 2 incubators simultaneously
- Seating for extra personnel
- Work top space
- Powered cool box
- Intercom/ camera / driver alert system
Rotary Wing (helicopter)
Helicopter transfer is the preferred transport mode when:
- There is an urgency of transport in relation to distances >170 kms.
- There is an urgency to provide a higher level of medical care than is available at the referral centre.
- Adverse road conditions impede ground transport.
The NNTP has developed a specific transport module for air transport that integrates into the Irish Air Corps’ EC135 and forthcoming AB 139 helicopters. This lighter weight incubator/ventilator system can be loaded safely and accommodated securely in these aircraft and also into NNTP and other national ambulances.
For whom is the NNTP Service intended?
The transport service is intended for any infant up to the age of six weeks who requires an increased level of care not available at the referring hospital. This care may include, but is not limited to speciality services including:
- Or a higher level of intensive care than is available at the referring hospital.
The majority of infants are transported to Dublin hospitals but the NNTP will also transport neonates to regional neonatal/surgical intensive care units nationally or internationally as required.