[Evaluation of sick neonates' medical interventions in maternity units before transport to reference centres]

Interhospital transfer of the sick neonate should be an integral part of neonatal intensive care. However, it is essential that the referring hospital is able to provide the appropriate standard of care from birth up to the point of transfer.

To evaluate the quality of medical interventions before interhospital transport of sick neonates.

Retrospective study based on review of all transport records of530 neonates who were transported at the Neonatal Intensive Care Unit (NICU) in 2006. The examined variables included medical interventions in the maternity unit and transport team interventions before and during the transport.

During the study period there was as a total of 530 transfers to Neonatology Departments, 325 of them (61.32%) were transferred to the NICU and 205 (38.68%) to the Special Care Unit. Within the group of neonates transported to the NICU, 51 (15.7%) infants had hypothermia, 65 (20%) had no venous access before the transport. The most common form of respiratory therapy was oxygen therapy (89 (27.4%) neonates), followed by mechanical ventilation (65 (20%) and NCPAP ventilation (50 (15.4%) infants). As a result of transport team interventions the number of children with hypothermia decreased to 27 (8.3%). Peripheral intravenous devices were inserted in 52 (16%) neonates. The number of infants transported on mechanical ventilation increased to 115 (35.4%), 56 (17.2%) babies received NCPAP and 53 (16.3%) were on supplemental oxygen. The highest number of transport team interventions was found in the group of extremely low birth weight infants.

Inadequate medical preparation of sick neonates in maternity hospital for interhospital transport was the reason for the high incidence of transport team interventions before moving the neonate to the NICU.