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Quality Assessment of Neonatal Transport performed by the Mobile Emergency Medical Services (SAMU)
Juliana C F Romanzeira1, Silvia W Sarinho1
1Universidade Federal de Pernambuco (UFPE), Recife, PE, Brazil.
Insights
Mobile Emergency Medical Services (SAMU) provided adequate neonatal transport. However, a significant decrease in body temperature was observed in 15% of neonates, impacting their stability during transport.
Area of Science:
- Neonatal care
- Emergency medical services
- Transport medicine
Background:
- Neonatal transport quality is crucial for infant outcomes.
- Assessing the efficiency of emergency medical services in neonatal care is essential.
- The Mobile Emergency Medical Services (Serviço de Atendimento Móvel de Urgência [SAMU]) in Brazil provides critical neonatal transport.
Purpose of the Study:
- To evaluate the quality and safety of neonatal transports conducted by SAMU.
- To identify potential complications and factors affecting neonatal stability during inter-facility transport.
- To assess the performance of SAMU in neonatal emergency care.
Main Methods:
- A cross-sectional, before-and-after observational study was conducted.
- The Transport Risk Index of Physiologic Stability (TRIPS) was used to assess neonatal status.
- Statistical analyses included Fisher's exact test, Student's t-test, and Mann-Whitney test.
Main Results:
- 33 neonates were transported, with respiratory failure being the primary reason for transport (42.4%).
- Mean transport time was 58 minutes with no reported medical or mechanical complications.
- A significant decrease in body temperature was observed in 15% of neonates, correlating with a worsened TRIPS score.
Conclusions:
- Neonatal transport by SAMU was generally adequate.
- Body temperature instability was the sole significant factor associated with altered TRIPS scores.
- Further attention to maintaining thermal stability during neonatal transport is warranted.
Objective:
To assess the quality of neonatal transport performed by the Mobile Emergency Medical Services (Serviço de Atendimento Móvel de Urgência [SAMU]).
Methods:
This was a cross-sectional before-and-after observational study. The study was carried out from March to August of 2013 using a validated instrument, the Transport Risk Index of Physiologic Stability (TRIPS), to assess the characteristics of the newborn, medical and mechanical complications (equipment and ambulance), and stability of newborns before and after transport. Tests were conducted with 95% confidence level. Numerical variables are represented by measures of central tendency and dispersion. Categorical variables were compared by Fisher's exact test. In the comparison of variables between the groups, the Student's t-test was used for variables with normal distribution, Fisher exact test, when appropriate, and the Mann-Whitney test, for non-normal distribution.
Results:
33 newborns were transported from low-risk units to neonatal intensive care units. Male gender (57.6%) and full-term gestational age (63.6%) were more prevalent. Birth weight<2,500g was found in 39.4% of newborns. Respiratory failure accounted for 42.4% of the requests. The mean transport time was 58 minutes without medical or mechanical complications. The TRIPS score worsened in 15% of neonates; in this group of infants, the mean initial temperature of 36.46±0.19 decreased significantly to 36.08±0.22 (p=0.041).
Conclusion:
The transport performed by the SAMU was adequate for most newborns. The oscillation in body temperature was the only significant variable for the alteration in the TRIPS score.
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