1. West Midlands Neonatal Transfer Service Therapeutic Hypothermia Cooling Audit Figures Apr 2012 – Dec 2012 Nikki Baker Neonatal Transport Nurse

2. West Midlands Neonatal Transfer Service Cooling Activity

3. West Midlands Neonatal Transfer Service Requests from

4. West Midlands Neonatal Transfer Service Transfers requests from each network

5. West Midlands Neonatal Transfer Service 11 Transfers Performed from each network

6. West Midlands Neonatal Transfer Service Transfer To

7. West Midlands Neonatal Transfer Service 17 14 Transfers performed To each network

8. West Midlands Neonatal Transfer Service Transfers performed Referral age

9. West Midlands Neonatal Transfer Service Transfers performed Response time (Call → Arrival on Ref. NNU)

10. West Midlands Neonatal Transfer Service Transfers performed Age at Cooling centre

11. West Midlands Neonatal Transfer Service Transfers performed Age 33-34°C Achieved

12. West Midlands Neonatal Transfer Service Transfers performed Methods of cooling

13. West Midlands Neonatal Transfer Service Transfers performed Babies not cooled

14. West Midlands Neonatal Transfer Service Transfers performed Respiratory support

15. West Midlands Neonatal Transfer Service Transfers performed Paralysis & sedation

16. West Midlands Neonatal Transfer Service Transfers performed Phenobarbitone use

17. West Midlands Neonatal Transfer Service Transfers performed Inotropic support

18. West Midlands Neonatal Transfer Service Stabilisation Stabilisation times varied from 1hour 17mins to 11hrs 55mins. Clinical factors influencing stabilisation included; ♦ Intubation♦ Umbilical line insertion ♦ X-ray confirmation♦ Loading dose phenobarbitone ♦ Starting morphine ♦ Starting inotropes Other factors influencing stabilisation included; ♦ Counselling parents♦ NTS shift handover ♦ TOBY paperwork♦ Discharge letter

19. West Midlands Neonatal Transfer Service The future Joint network therapeutic hypothermia study day; Early recognition of babies meeting criteria Early clinical management of these babies Rapid referral to Cooling Centre Rapid referral to NTS. All neonatal units using rectal temperature monitoring as gold standard. Use of Tecotherm mattress on transfers; Earlier achievement of 33-34°C Reducing incidents of temperature fluctuations Plans for an educational DVD on early management of cooling babies.