Mishra Neeraj, Saini Shiv Sajan, Jayashree Muralidharan, Kumar Praveen
Department of Pediatrics, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
Indian J Community Med. 2022 Apr-Jun;47(2):253-257. doi: 10.4103/ijcm.ijcm_889_21. Epub 2022 Jul 11.
This study was planned to study the existing status of neonatal transport in North India after the introduction of National Ambulance Service (NAS). We evaluated the quality of referral, admission status, and outcome of referred neonates.
We enrolled neonates admitted between March 2016 and October 2016, excluding neonates referred from the outpatient department. Information was collected from referral slips, interviewing accompanying persons and observation.
Sixty-one percent were referred from government hospitals with "sick newborn care units" contributing to maximum. The main mode of transport was ambulance in 80% and referral notes were available in the majority but incomplete in majority. Sepsis (39%), jaundice (16%), and birth asphyxia (13%) were the most common diagnoses. Half of the neonates were hemodynamically unstable. Twenty-seven percent had poor circulation, 15% were hypoxic, 9% hypoglycemic, and 8% hypothermic. Twenty-two percent either died or "left against medical advice" with a high probability of death.
NAS is utilized for transporting neonates. However, there are quality gaps which need attention to develop it into efficient referral system.
本研究旨在探讨在引入国家救护车服务（NAS）后印度北部新生儿转运的现状。我们评估了转诊质量、入院情况以及转诊新生儿的结局。
我们纳入了2016年3月至2016年10月期间入院的新生儿，但不包括来自门诊部转诊的新生儿。信息通过转诊单收集，询问陪同人员并进行观察。
61%的新生儿来自设有“患病新生儿护理单元”的政府医院，占比最大。主要的转运方式是救护车，占80%，大多数有转诊记录，但大多数记录不完整。脓毒症（39%）、黄疸（16%）和出生窒息（13%）是最常见的诊断。一半的新生儿血流动力学不稳定。27%循环不良，15%缺氧，9%低血糖，8%体温过低。22%的新生儿死亡或“自动出院”，死亡可能性很大。
NAS用于转运新生儿。然而，存在质量差距，需要加以关注以将其发展成为高效的转诊系统。
