Transport of a Neonate

NICU hospital in bangalore
Whatever be the reason for transporting a neonate, from one hospital to another or within the same hospital (from operating room to NICU), maintenance of body temperature, oxygenation and glucose levels are important.

Retrieval services for critically ill newborn

Columbia Asia Hospital provides retrieval services from primary care hospitals, nursing homes and other medical establishments for critically ill neonates requiring ICU services.

Health care professionals from other centres who want to shift a patient to Columbia Asia Hospital can contact the hospital to facilitate early activation of the retrieval team and ensure timely transfer and prompt initiation of definitive care. The mother should preferably be shifted with the baby.

On receiving a call from a hospital, the NICU doctor of Columbia Asia Hospitals interacts with the treating doctors to ascertain the status of the baby. The retrieval team goes to get the baby in an ambulance with all facilities.

Conditions for which retrieval services are offered:

  • Prematurity (always discuss/consider the possibility of intra uterine transfer if time permits, as this significantly reduces the morbidity for babies)
  • Term babies with breathing difficulty
  • Babies with significant jaundice with possible need for exchange transfusion
  • Neonates needing surgical treatment (after discussing with paediatric surgeon at Columbia Asia hospital where facilities exist)
  • Primary consultant feels that the baby needs to be investigated and managed further at a higher centre (after discussing with the consultant)
  • Neonates who require sepsis workup and treatment
**It is important to ascertain that the baby is not too sick (needing maximal pressure support/ high oxygen/ inotropic support) to ensure retrieval is safe and effective

In Utero Transfer

  • When it is anticipated prior to delivery that a baby may require intensive or high dependency care, and this is not available locally, in-utero transfer should occur provided this does not jeopardise the mother’s health or risk delivery on route.
  • The mother’s womb is the best incubator for the baby to be transported in.

Indications for in utero transfer

Pregnancy Less than 32 weeks
Estimated fetal weight Less than 1500 gms
Multiple pregnancy Less than 34 weeks
Severe Rhesus disease Requiring pre-term delivery
Congenital defects detected on antenatal ultrasound scans likely to need immediate post natal surgery Congenital heart defects, diaphragmatic hernia, intestinal obstruction, renal tract dilatation, brain and spinal malformations, tumors

Ex utero transfer

Indications

  • Infants needing oxygen for more than 4 hours
  • Infants needing more than 60 % oxygen
  • Associated with apnoea
  • Associated with meconium aspiration
  • Congenital defects
  • Weight below 1500 gms
  • Recurrent apnoea and convulsions
  • Severe birth asphyxia
  • Jaundice with need for exchange transfusion
  • Bleeding neonate
  • Infant needing surgery
  • Infants with lethargy, poor feeding, cyanosis, vomiting

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