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West Midlands Neonatal Transfer Service WMNTS Transport User Group Meeting Monday 21 st October...
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Transcript of West Midlands Neonatal Transfer Service WMNTS Transport User Group Meeting Monday 21 st October...
![Page 1: West Midlands Neonatal Transfer Service WMNTS Transport User Group Meeting Monday 21 st October 2013.](https://reader038.fdocuments.in/reader038/viewer/2022110205/56649c775503460f9492cbd1/html5/thumbnails/1.jpg)
West Midlands Neonatal Transfer Service
WMNTS Transport User Group Meeting
Monday 21st October 2013
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West Midlands Neonatal Transfer Service
Referrals April – Sept 2013
Network to Network
Network to Outside
Network to CNN
CNN to Outside
Outside to Network
CNN to CNN
Outside to Outside
CNN to Network
0
100
200
300
400
500
600549
3815 0
440 0 12
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West Midlands Neonatal Transfer Service
Trend with Time
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West Midlands Neonatal Transfer Service
Accepted Transfers April- Sept 2013
Network to Network
Network to Outside
Network to CNN
CNN to Outside
Outside to Network
CNN to CNN
Outside to Outside
CNN to Network
0
100
200
300
400
500
600
700 658
549
3815 0
440 0 12
545
466
28 8 038
0 0 6
Requested Transferred
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West Midlands Neonatal Transfer Service
Types of Transfer
208
67
270
ITU HD SC
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West Midlands Neonatal Transfer Service
Categories of Transfer
Medical Surgical Cardiac Neuro /cooling0
50
100
150
200
250
300
350
400
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West Midlands Neonatal Transfer Service
Level of Transfer
Uplift
Capacity
Repatriation
Out Patients
0 50 100 150 200 250 300
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West Midlands Neonatal Transfer Service
Timing
Within 1 hr Within 4 hrs Within 24 hrs >24 hours0
50
100
150
200
250
300
350
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West Midlands Neonatal Transfer Service
Categories of Transfer
545 55 108 38 248 15 1 49 23 8Transferred IPPV Surgical Cardiac Back
transferSpecialist Palliative
CareCot
MngtCooling Radiology/
OPA
0
50
100
150
200
250
300
350
400
450
500
Network to Network
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West Midlands Neonatal Transfer Service
Cooling
April
May
June Ju
ly
Augus
t
Septe
mbe
r0
2
4
6
8
10
TotalSWMNNSSBCNN
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West Midlands Neonatal Transfer Service
Incidents
Number Of Incidents
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West Midlands Neonatal Transfer Service
Time critical transfers
100% SSBCNN (6) 71% SWMNN (2 – both on call)
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West Midlands Neonatal Transfer Service
Clinical case
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West Midlands Neonatal Transfer Service
Twin II
Referral at 21:30 Mobilisation 21:45 Arrival 22:15 Decision made to move twin II 1st as more
stable 18/6 x 0.33 x 50 – 99% saturated Awaiting xray (done 23:00) Temp 33.5 – incubator temp & transwarmer UAC not tracing; cuff bp 21-24 (bolus given)
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West Midlands Neonatal Transfer Service
Twin II
Xrays reviewed ET (6.5cm) @ T5 withdrawn 0.5cm – to 6cm UAC (T10) withdrawn to L3-4 (2.5cm) UVC – at diaphragm
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West Midlands Neonatal Transfer Service
Twin II
Repeat gas – no changes Temp 36.2 @23:30 Dopamine & dobutamine commenced at
10/10 – mean bp >25 subsequently (00:00) Temp 37.5 @ 24:00 Repeat gas – no changes Transferred into WMNTS incubator
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West Midlands Neonatal Transfer Service
Twin II
ET noted at 4cm - ? Dislodged; weak response pedicap
Reintubated in transport incubator – fixed at 6 cm; repeat dislodged ET- reintubated
Repeat xray ET T3 Repeat ABG – pCO2 3.5 – PIP and I time
decreased Transferred on 20/5x 50 x24%
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West Midlands Neonatal Transfer Service
Twin II
Uneventful transfer
Incident generated for hypothermia
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West Midlands Neonatal Transfer Service
Twin I
Arrived referring unit 04:05
21/5 x 60 x 78% - sats 96% Dobutamine & dopamine – BP maintained ABG pH 7.16, pCO2 8.89 Unable to deliver HFO in transfer 2nd curosurf & PIP @23
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West Midlands Neonatal Transfer Service
Twin I
Transferred into incubator Hypertensive – inotropes stopped Repeat ABG – pCO2 7.5
Uneventful transfer to New Cross Arrived @ 06:50
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West Midlands Neonatal Transfer Service
Staffing
Continue to have Deanery trainee 1x ANNP post filled with clinical fellow 1x ANNP rotational post 1 nurse rotation 1 nurse secondment 2 student ANNPs 2 nurse vacancies SSBCNN consultant post filled
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West Midlands Neonatal Transfer Service
Rota
Resident 4 nights of week (mon-thurs)
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West Midlands Neonatal Transfer Service
New Equipment
Techotherm in use 2 Inditherm mattresses bought Glucometer in response to clinical incidents New ambulances
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West Midlands Neonatal Transfer Service
Education
Cooling study day WMNTS training day Dec 13
Staff involved in MSc Advanced Practice programme & Undergraduate education
Staff involved in MLU education programme
1x GIC completed
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West Midlands Neonatal Transfer Service
Future developments
Cot locator seconded to KIDS for 6 months to support NVSN
Working with commissioners, QIP etc to achieve NIC transport specifications (gap analysis – teleconferencing & dedicated 24/7 consultant support)