1. West Midlands Neonatal Transfer Service WMNTS Transport User Group Meeting Monday 21 st October 2013

2. West Midlands Neonatal Transfer Service Referrals April – Sept 2013

3. West Midlands Neonatal Transfer Service Trend with Time

4. West Midlands Neonatal Transfer Service Accepted Transfers April- Sept 2013

5. West Midlands Neonatal Transfer Service Types of Transfer

6. West Midlands Neonatal Transfer Service Categories of Transfer

7. West Midlands Neonatal Transfer Service Level of Transfer

8. West Midlands Neonatal Transfer Service Timing

9. West Midlands Neonatal Transfer Service Categories of Transfer

10. West Midlands Neonatal Transfer Service Cooling

11. West Midlands Neonatal Transfer Service Incidents

12. West Midlands Neonatal Transfer Service Time critical transfers 100% SSBCNN (6) 71% SWMNN (2 – both on call)

13. West Midlands Neonatal Transfer Service Clinical case

14. West Midlands Neonatal Transfer Service Twin II Referral at 21:30 Mobilisation 21:45 Arrival 22:15 Decision made to move twin II 1 st 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)

15. West Midlands Neonatal Transfer Service Twin II Xrays reviewed ET (6.5cm) @ T5 withdrawn 0.5cm – to 6cm UAC (T10) withdrawn to L3-4 (2.5cm) UVC – at diaphragm

16. 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

17. 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%

18. West Midlands Neonatal Transfer Service Twin II Uneventful transfer Incident generated for hypothermia

19. 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 2 nd curosurf & PIP @23

20. 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

21. 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

22. West Midlands Neonatal Transfer Service Rota Resident 4 nights of week (mon-thurs)

23. West Midlands Neonatal Transfer Service New Equipment Techotherm in use 2 Inditherm mattresses bought Glucometer in response to clinical incidents New ambulances

24. 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

25. 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)