Helicopter transport of sick neonates: a 14-year population-based study.

Abstract

The Norwegian Helicopter Emergency Medical Service (HEMS) employs anesthesiologists and paramedics who are not formally trained in neonatology to provide stabilization and transport of sick neonates. We describe neonatal transport by HEMS in central Norway and report the outcome. Retrospective analysis of HEMS missions during the 14-year period 1988-2001. A total of 252 neonates were transported, indicating a prevalence of 0.90 per 100 newborn. Median response time was 42 min, on-scene stabilization time 38 min and transportation time 30 min. Median gestational age (GA) was 38 weeks and 4.8% of the neonates were <1000 g and/or <28 weeks. Main clinical problems were respiratory disease, asphyxia and malformations; 30 neonates (12%) died within 1 year. No deaths were transport-related. Tube or ventilator problems were noted in seven out of 66 transports of ventilated neonates. Other technical problems were few. Regarding ventilation, oxygenation and circulation, the clinical condition of most neonates improved during transport and the median temperature rose from 36.5 degrees C to 37.0 degrees C. Hypoglycemia (<2 mmol l(-1)) was documented in 19 missions after transport; of these, eight received a glucose infusion. Four neonates might have profited from HEMS-delivered surfactant therapy. Helicopter Emergency Medical Service in central Norway provides rapid medical assistance in a wide spectrum of neonatal problems, but more attention should be paid to proper ventilation and prevention of hypothermia and hypoglycemia.