Tette Edem M A, Nuertey Benjamin D, Akaateba Dominic, Gandau Naa Barnabas
Department of Community Health, University of Ghana Medical School, P.O. Box 4236, Accra, Ghana.
Public Health Department, Tamale Teaching Hospital, P.O. Box TL 16, Tamale, Ghana.
Children (Basel). 2020 Mar 20;7(3):22. doi: 10.3390/children7030022.
Optimum care of sick neonates often involves transporting them across different levels of care. Since their condition may deteriorate over time, attention needs to be paid to travel distances and how they are transferred. We examined the mode of transport, distances travelled, condition on arrival and outcome of outborn neonates admitted to a district and a regional hospital in Ghana using a cross-sectional study involving caregivers of neonates admitted to these hospitals. Information on referral characteristics and outcome were obtained from questionnaires and the child's case notes. Overall, 153 caregivers and babies were studied. Twelve deaths, 7.8%, occurred. Neonates who died spent a median duration of 120 min at the first health facility they visited compared with 30 min spent by survivors; they travelled mostly by public buses, (41.7%), compared with 36.0% of survivors who used taxis. Majority of survivors, 70.2%, had normal heart rates on arrival compared with only 41.7% of neonates who died; hypothermia was present in 66.7% compared with 47.6% of survivors. These findings indicate that the logistics for neonatal transport were inadequate to keep the neonates stable during the transfer process, thus many of them were compromised especially those who died. Further studies are warranted.
患病新生儿的最佳护理通常涉及将他们转运至不同级别的医疗机构。由于他们的病情可能随时间恶化，因此需要关注转运距离以及转运方式。我们采用横断面研究，对加纳一家区级医院和一家区域医院收治的外转新生儿的转运方式、转运距离、入院时状况及转归进行了调查，研究对象为这些医院收治新生儿的护理人员。关于转诊特征和转归的信息通过问卷调查及患儿病历获得。总共对153名护理人员和婴儿进行了研究。有12例死亡，占7.8%。死亡新生儿在其就诊的第一家医疗机构停留的中位时间为120分钟，而存活者为30分钟；他们大多乘坐公共汽车转运（41.7%），而使用出租车转运的存活者占36.0%。大多数存活者（70.2%）入院时心率正常，而死亡新生儿中只有41.7%心率正常；66.7%的死亡新生儿存在体温过低，而存活者中这一比例为47.6%。这些研究结果表明，新生儿转运的后勤保障不足以在转运过程中使新生儿保持稳定，因此许多新生儿受到影响，尤其是那些死亡的新生儿。有必要进行进一步研究。
