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PrePre--HospitalHospital
NeonatalNeonatal Intensive Care:Intensive Care:
a a possiblepossible challengechallenge??
Dr. Angelo Giusto, MDDr. Angelo Giusto, MD
NeonatalNeonatal Intensive CareIntensive Care
Giannina Giannina GasliniGaslini Children’Children’s Hospital, s Hospital, GenoaGenoa
SeptemberSeptember 11 11 –– 15, 200615, 2006
FocusedFocused historyhistory
�� In In italyitaly the the prepre--hospitalhospital EMS EMS startedstarted in in 19921992
�� Some Some institutionsinstitutions startedstarted immediatlyimmediatly, , otherother startedstarted in 2004!in 2004!
�� ThereThere are no are no schoolsschools forfor physicianphysician, , forfortraining in training in emergencyemergency medicinemedicine
�� At At presentpresent, in , in ItalyItaly: BLS, ACLS, ATLS, : BLS, ACLS, ATLS, PHTLS, PBLS, PALS, PTC and, in the PHTLS, PBLS, PALS, PTC and, in the lastlastyearyear, the PEPP , the PEPP coursecourse
NumbersNumbers -- 11
PediatricsPediatrics emergenciesemergencies: :
lessless the 3% of the the 3% of the entireentire numbernumber of of callcall
adults
childs
NumbersNumbers -- 22
NeonatalNeonatal emergenciesemergencies: : whatwhat percentagepercentage??
adults
childs??
What’What’s new s new aroundaround
�� StatisticsStatistics show the show the needneed forfor of a “full of a “full focusfocus” ” aboutabout pediatricspediatrics and and newbornnewborn carecare
�� StatisticsStatistics show show thatthat manymany newbornnewborn are are treatedtreated byby prepre--hospitalhospital emergencyemergencyservicesservices
�� FromFrom thesethese twotwo stepssteps, , prepre--hospitalhospitalprofessionalsprofessionals mustmust knowknow the “the “newbornnewborn & & neonatalneonatal entityentity” and the ” and the treatementstreatements thatthattheythey maymay requirerequire
PresentPresent situationsituation
�� NotNot allall the the prepre--hospitalhospital professionalsprofessionals havehave
the the samesame training and the training and the samesame “cursus “cursus
studiorumstudiorum”;”;
�� NotNot allall prepre--hospitalhospital professionalsprofessionals are are wellwell--
trainedtrained;;
�� PediatricPediatric emergenciesemergencies and and expeciallyexpecially
neonatalneonatal stabilizationstabilization are are uncommonuncommon
featuresfeatures
ObjectivesObjectives, , expectationsexpectations
�� EachEach physicianphysician mustmust knowknow the the uniqueunique, , particularparticular featuresfeatures of of newbornsnewborns, , includingincluding::�� PhysiopatologyPhysiopatology of of pregnancypregnancy
�� PhysiopatologyPhysiopatology of of laborlabor and deliveryand delivery
�� AnatomicAnatomic featuresfeatures of of newbornsnewborns
�� PhysiologicPhysiologic featuresfeatures of of newbornsnewborns
�� FoundationsFoundations of of neonatalneonatal stabilizationstabilization and and resuscitationresuscitation
�� EachEach phisycianphisycian, in the , in the prepre--hospitalhospitalemergencyemergency serviceservice, , mustmust bebe ableable toto treattreatanan illill newbornnewborn
ThereThere isis onlyonly a a questionquestion::
Are Are wewe readyready??
At the moment, At the moment,
therethere isis onlyonly anan answeranswer::
NO!NO!
WhatWhat can (or can (or mustmust) ) wewe do?do?
Training!Training!
Training!Training!Training!Training!
Training!Training!
Training!Training!
Training!Training!Training!Training!
HowHow??
1)1) TestingTesting the the locallocal resourcesresources, , checkingchecking the the
prepre--hospitalhospital professionalsprofessionals preparationpreparation, ,
accordingaccording toto needsneeds;;
2)2) DevelopeDevelope a training program, common a training program, common toto
allall phisycianphisycian, in , in orderorder toto obtainobtain a a
standard in the standard in the serviceservice;;
3)3) ReferRefer toto hospital hospital professionalsprofessionals and, and,
moreovermoreover makemake useuse of of children’children’s hospital s hospital
training training programsprograms;;
4)4) AcquireAcquire the the conceptconcept thatthat a a childrenchildren are are
notnot a a smallsmall adultadult!!!!!!
WhyWhy??
……forfor themthem, , itit isis mostmost importantimportant!!
QuestionsQuestions??
PrePre--HospitalHospital
NeonatalNeonatal Intensive Care:Intensive Care:
a a possiblepossible challengechallenge??
Dr. Angelo Giusto, MDDr. Angelo Giusto, MD
NeonatalNeonatal Intensive CareIntensive Care
Giannina Giannina GasliniGaslini Children’Children’s Hospital, s Hospital, GenoaGenoa
SeptemberSeptember 11 11 –– 15, 200615, 2006
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