Children’s Transport

Give overview of personnel dedicated to transporting critically ill neonates Describe relationship with our transport system and it’s scope within our region Describe the referral process from the regional hospital to our larger medical center Describe process of back transfers

Children’s Transport Team RNs specially trained in both pediatric and neonatal critical care as well as ground/flight transport duties Must have at least 3 years experience in emergency or critical care nursing BSN preferred Achieve certification in specialty within 3 years BLS, PALS, NRP, EMT Quarterly education/simulation requirements Developed dedicated neonatal team in 2016 to assure optimal quality of care for our smallest and medically fragile patients Our team has since evolved to include pediatric transports under the age of 6 Work in conjunction with our existing transport infrastructure-EastCare Currently a team of 6 to cover 24/7. Finding right fit and training is a long process

Goal Provide ICU level care beginning from the time of arrival of team at referring facility throughout the transport process until admission to NICU Generally considered a MICU level transport-Mobile Intensive Care Unit Any patient requiring or possibly requiring extensive monitoring or interventions. Task load may quickly overwhelm a single provider. Staffed with three or more personnel: EMT or Paramedic Driver Paramedic and RN Alternate: RN and RN May bring a fellow or neonatal APP if needed

EastCare’s Scope 33 Counties in Eastern North Carolina 21 Hospitals – primary Fire & EMS Services primarily in 33 county area Additional 15 surrounding counties mutual aide Patients requiring Critical Care Transport by ground or air Bases are strategically located in the region Located to optimize response times Cover another area when that resource is busy   Air Response•Attempt to have “1st in” aircraft within 15 minutes Ground Response•Attempt to have “1st in” truck within 30 minutes CAMTS accrediting –Comission on Accreditation for Medical Transport Services

Service Area EastCare was the first accredited flight service east of the Mississippi EastCare has highest call volume per air frame in the world. EastCare performs about 2,400 flights and about 8,000 ground transports per year. Established April 1985 Ground services established 1994

Response Times

Referral Process REFERRING PEDIATRICIAN -OUTREACH CONNECTIONS -RELATIONSHIP BUILDING -EDUCATIONAL SUPPORT EASTCARE COMMUNICATION CENTER ORGANIZES MOST EFFICIENT TX PLAN WITH TX SUPERVISOR DISPATCHES TX TEAM VIA AIR or GROUND NEONATAL ATTENDING PHYSICIAN/ FELLOW CONSULTS/ ACCEPTS TRANSFER ACTS AS RESOURCE FOR REFERRING MD/MEDICAL CONTROL FOR TX TEAM

2018 Neo Transfers Facility Albemarle Vidant Beaufort 8 Camp Lejeune 9   Vidant Beaufort 8 Vidant Chowan 15 Vidant Duplin 13 Vidant Edgecombe 16 Vidant Outer Banks Vidant Roanoke Chowan 14   Albemarle Camp Lejeune 9 Carolina East 25 Carteret 11 Halifax 20 Lenoir Martin 15 Nash 8 Onslow 1 Wayne 34 Wilson 27

Back Transfers Discussion with parents begins early in NICU stay Home hospital level of care often determines ability to transfer back Facilitated by case manager EastCare transports back to home hospital 1/3 air 2/3 ground For neo/peds combined

Questions?