1. Neonatal Transport Fred Hill, MA, RRT

2. Maternal Transport Ideal method of transport Also, called in utero

3. Methods of Transport Ground (<100 miles) –Ambulance –Special transport van Air –Helicopter (100 to 250 miles) –Fixed wing (>250 miles)

4. Ground Transport Advantages –No need for landing sites –Not limited by inclement weather –More work area –Relatively quiet environment Disadvantages –Time factor with great distances –Terrain and water (islands) may limit use

5. Helicopter Advantages Fast Does not require landing strip Disadvantages Noise and vibration May be grounded in certain weather conditions Small work area Lighting may impact pilot’s vision Weight limitations Highly trained crew Expensive Hypobaric effects

6. Fixed-Wing Airplane Advantages –Fastest –Less noise and vibration –Higher altitudes, may bypass bad weather –May be more room Disadvantages –Must land at airport, needing ground transport –Maybe grounded –Small work area –Hypobaric effects –Expensive

7. Effects of Altitude & Flying Changes in partial pressure of oxygen Expansion of gases in closed spaces Pneumothorax Gas in bowel Effects on blood supply to brain based on acceleration and deceleration Noise levels may increase stress and/or cause hearing loss Weight and space limitations may limit parent to accompany infant

8. Personnel RN & RRT MD & RN RN & RN MD & RN & RRT

9. Personnel Many skills –Intubation –IV access –UAC placement –Chest tube placement –Well versed and experienced in resuscitation Usually cross trained

10. Special Aspects Cylinders for gas supplies –Determination of duration of cylinder gases –Transport ventilator run by gases (fluidics) or battery powered (conversion from DC to AC powered) Thermoregulation more difficult Stabilization accomplished at referring hospital