Gardiner Jacqueline, McDonald Kylie, Blacker Joanne, Athikarisamy Sam, Sharp Mary, Davis Jonathan
Newborn Emergency Transport Service WA, Perth Children's Hospital, Child and Adolescent Health Service, Perth, Western Australia, Australia.
Neonatal Directorate, King Edward and Perth Children's Hospital, Child and Adolescent Health Service, Perth, Western Australia, Australia.
J Pediatr Clin Pract. 2024 Mar 14;11:200102. doi: 10.1016/j.jpedcp.2024.200102. eCollection 2024 Mar.
To compare unintended events in transfers performed by neonatal specialist (NS) and non-neonatal specialist (NNS) teams in Western Australia (WA).
Retrospective comparison of neonatal transfers from the Kimberley and Pilbara regions (WA) to tertiary services, King Edward Memorial (perinatal) and Perth Children's Hospital Neonatal Intensive Care Unit, in Perth (state capital, distance up to 2200 km) between January 2018 and June 2021. NS teams traveled from the tertiary to the referring center and back. NNS traveled from the referring to the tertiary center. Transport time, team composition, total unintended clinical and endotracheal tube (ETT) events were compared. Categorial data are expressed as numbers (%) and compared by χ test; continuous data are expressed as median (IQR) and compared by Mann-Whitney test.
During the study period, 3709 infants were transported in WA to tertiary services for escalation of care: 119 of 3709 (3.2%) from the Kimberley and Pilbara, 49 with NS and 70 with NNS teams. NNS had shorter transport times than NS teams (508 [433-610] vs 675 [610- 735] minutes; < .0001). Neonatal nurses were on NS more than NNS teams (36/49 [73.5%] vs 6/70 [8.6%]; RR 5.08, 95% CI 3.13-8.56, < .001). Total unintended clinical and ETT events were less in NS vs NSS teams (28/49 [57%] vs 54/70 [77%]; RR 0.66, 95% CI 0.40-0.92, = .03) and (0/26 [0%] vs 7/23 [30%]; = .004).
Although NS teams had longer transport times, there were fewer unintended clinical and ETT events. NS teams should be considered as the first choice to undertake neonatal transport.
比较西澳大利亚州（WA）新生儿专科（NS）团队和非新生儿专科（NNS）团队在转运过程中的意外事件。
对2018年1月至2021年6月期间从金伯利和皮尔巴拉地区（WA）转运至三级医疗机构（珀斯的爱德华国王纪念医院（围产期）和珀斯儿童医院新生儿重症监护病房，州首府，距离可达2200公里）的新生儿转运情况进行回顾性比较。NS团队从三级医疗机构前往转诊中心再返回。NNS团队从转诊机构前往三级中心。比较了转运时间、团队组成、总的意外临床事件和气管内插管（ETT）事件。分类数据以数字（%）表示，并通过χ检验进行比较；连续数据以中位数（IQR）表示，并通过曼-惠特尼检验进行比较。
在研究期间，西澳大利亚州有3709名婴儿被转运至三级医疗机构以加强护理：金伯利和皮尔巴拉地区的3709名婴儿中有119名（3.2%），其中49名由NS团队转运，70名由NNS团队转运。NNS团队的转运时间比NS团队短（508[433 - 610]分钟对675[610 - 735]分钟；<0.0001）。NS团队中的新生儿护士比NNS团队多（36/49[73.5%]对6/70[8.6%]；RR 5.08，95%CI 3.13 - 8.56，<0.001）。NS团队的总的意外临床事件和ETT事件比NSS团队少（28/49[57%]对54/70[77%]；RR 0.66，95%CI 0.40 - 0.92，=0.03）以及（0/26[0%]对7/23[30%]；=0.004）。
尽管NS团队的转运时间更长，但意外临床事件和ETT事件较少。NS团队应被视为进行新生儿转运的首选。
