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Methods for In Vivo Biomechanical Testing on Brachial Plexus in Neonatal Piglets
Published on: December 19, 2019
Has discomfort during neonatal transfers improved over time?
Ashley Timings-Thompson1, Sally Courtney2, Catherine Harrison2,3,4
1Embrace Transport Service, Sheffield Children's Hospital Foundation Trust, Sheffield, UK. a.timings-thompson@nhs.net.
Insights
Neonatal pain scores increase during transport, with current infants showing higher discomfort than a decade ago. Despite equipment advances, further strategies are needed to reduce infant pain during transfer.
Area of Science:
- Neonatal care
- Transport medicine
- Pain assessment
Background:
- Neonatal pain during transport is under-researched.
- Previous studies indicated pain increases during transit.
Purpose of the Study:
- To evaluate neonatal pain during transport.
- To compare current pain scores with historical data.
- To assess the impact of transport process developments on pain.
Main Methods:
- Prospective cohort study of 113 infants.
- Utilized the Premature Infant Pain Profile (PIPP) for pain assessment.
- Measured pain at five time points during transport, including baseline.
Main Results:
- PIPP scores increased during transport, peaking upon arrival.
- Current PIPP scores were higher than 2009 data when compared to baseline.
- Pain patterns remained similar to 2009, despite equipment advancements.
Conclusions:
- Infants experience significant discomfort during transport.
- Current transport methods do not appear to have reduced neonatal pain levels.
- Further interventions are necessary to mitigate pain during neonatal transfer.
Abstract:
The aim of this study was to evaluate neonatal pain during neonatal transfer. Comparison with previous published data was carried out to assess if the increase in neonatal pain scores seen during transport was mitigated by developments in the transport process and equipment. This is a prospective cohort study on all infants transported by Embrace, Yorkshire and Humber Infant and Children's Transport Service over a 12-month period. The Premature Infant Pain Profile (PIPP) was used to measure stress and discomfort at five specified times during transport. The score before any interventions/transport at the referring unit was used as the baseline. A total of 113 babies had complete data and were included in final analysis. PIPP scores from our 2024 data showed a similar pattern to 2009, with the PIPP scores increasing during the transport process and peaking on arrival at the receiving unit. When compared to baseline scores, PIPP score data from this study was higher than the 2009 data. Conclusion: Infants continue to demonstrate high levels of discomfort during the transport process. Despite advances in transport equipment, our current cohort showed higher levels of discomfort compared to 2009 when against their respective baseline scores. What is Known: • Discomfort and pain have been studied in the NICU setting but data is limited in the transport environment. What is New: • This study shows that neonatal pain scores increase during the transport process. Despite efforts to mitigate this, current PIPP scores are higher than our previous cohort. • Further considerations need to be made to reduce neonatal pain during transport.
