Long-distance transfer of unwell neonates: A case series

The Northern Territory Neonatal Emergency Transport Service (NETS NT) pilot was created in April 2018 to expedite the transfer of critically unwell neonates to specialised interstate centres. The aim of this paper is to describe long-distance retrievals undertaken during the first 3 years of operation of the service.

A case series is described comprising neonates requiring long-distance aeromedical transfer (>2500 km) by NETS NT between April 2018 and June 2021. Data were obtained from hospital and transport service documentation. This was supplemented by four semi-structured interviews with transport staff.

Thirty neonates were transferred via NETS NT during the investigation period, including 19 transfers >2500 km. Of these, 18/19 (94.7%) required respiratory support, 8/19 (42.1%) were intubated and 4/19 (21.1%) required inotropic support. The average length of transport was 7.5 h (5.6-8.9). Twelve patients had in-flight documentation available. Eight required increased oxygen administration 8/12 (66.6%). The median change in FiO₂ was an increase of 0.02 (-0.05 to 0.45).

The NETS NT has been successfully established to transport high-risk neonates to interstate quaternary health services when required. Future recommendations for the service include ongoing implementation of systems and processes to strengthen all aspects of governance and operations using suitably adapted resources from established Australian retrievals services.