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WMNTS Transport User Group Meeting. Monday 21 st October 2013. Referrals April – Sept 2013. Trend with Time. Accepted Transfers April- Sept 2013. Types of Transfer. Categories of Transfer. Level of Transfer. Timing. Categories of Transfer. Cooling. Incidents. Time critical transfers. - PowerPoint PPT Presentation
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West Midlands Neonatal Transfer Service
WMNTS Transport User Group Meeting
Monday 21st October 2013
West Midlands Neonatal Transfer Service
Referrals April – Sept 2013
Network to Network
Network to Outside
Network to CNN
CNN to Outside
Outside to Network
CNN to CNN
Outside to Outside
CNN to Network
0
100
200
300
400
500
600549
3815 0
440 0 12
West Midlands Neonatal Transfer Service
Trend with Time
West Midlands Neonatal Transfer Service
Accepted Transfers April- Sept 2013
Network to Network
Network to Outside
Network to CNN
CNN to Outside
Outside to Network
CNN to CNN
Outside to Outside
CNN to Network
0
100
200
300
400
500
600
700 658
549
3815 0
440 0 12
545
466
28 8 038
0 0 6
Requested Transferred
West Midlands Neonatal Transfer Service
Types of Transfer
208
67
270
ITU HD SC
West Midlands Neonatal Transfer Service
Categories of Transfer
Medical Surgical Cardiac Neuro /cooling0
50
100
150
200
250
300
350
400
West Midlands Neonatal Transfer Service
Level of Transfer
Uplift
Capacity
Repatriation
Out Patients
0 50 100 150 200 250 300
West Midlands Neonatal Transfer Service
Timing
Within 1 hr Within 4 hrs Within 24 hrs >24 hours0
50
100
150
200
250
300
350
West Midlands Neonatal Transfer Service
Categories of Transfer
545 55 108 38 248 15 1 49 23 8Transferred IPPV Surgical Cardiac Back
transferSpecialist Palliative
CareCot
MngtCooling Radiology/
OPA
0
50
100
150
200
250
300
350
400
450
500
Network to Network
West Midlands Neonatal Transfer Service
Cooling
April
May
June Ju
ly
Augus
t
Septe
mbe
r0
2
4
6
8
10
TotalSWMNNSSBCNN
West Midlands Neonatal Transfer Service
Incidents
Number Of Incidents
West Midlands Neonatal Transfer Service
Time critical transfers
100% SSBCNN (6) 71% SWMNN (2 – both on call)
West Midlands Neonatal Transfer Service
Clinical case
West Midlands Neonatal Transfer Service
Twin II
Referral at 21:30 Mobilisation 21:45 Arrival 22:15 Decision made to move twin II 1st 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)
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
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
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%
West Midlands Neonatal Transfer Service
Twin II
Uneventful transfer
Incident generated for hypothermia
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 2nd curosurf & PIP @23
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
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
West Midlands Neonatal Transfer Service
Rota
Resident 4 nights of week (mon-thurs)
West Midlands Neonatal Transfer Service
New Equipment
Techotherm in use 2 Inditherm mattresses bought Glucometer in response to clinical incidents New ambulances
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
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)
