My First Transport

prmenrs, RN · Dec 5, 2006

Well, in this case, I guess not! Baby ate well. @ that point, I'm sure the milk was just dripping into the babies mouth. Once the let-down is triggered, the milk comes out. All baby had to do was swallow. This happened many years ago (pre-AIDS, Hep B days), and I'm pretty sure she had no problem getting that baby to eat.

Zippedodah · Dec 5, 2006

For those of you that don't go with a doc, what would you do if the kid turned bad, really bad and you were on the road? I'm glad we take a fellow, because there have been times when we got there and the kid was not just a regular old TTN...it was a full blown I'm-going- into- PPHN- and- down- the- tubes- about- to- circle- the- drain kid!

2curlygirls · Dec 6, 2006

We go with the RNTS (most of whom are NNP's) or the fellow. SOmetimes an RT if they need iNO, are cardiac, or otherwise unstable. We are in contact with the attending.

Sweeper933 · Dec 7, 2006

I can't imagine going out on transport w/o a doc! We only do ambulance here - we're too close to the EL to do any helicopter transports. We always take a doc, and 1-2 RNs depending on how sick/little the baby is, and depending on our staffing as well. The last transport I went on was for a 25 weeker. When we ge there and start asking their RNs about vitals and stuff - we are told that the last temp 5 min ago was 88.1!!! Yes I typed that correctly, 88.1 degrees. Yikes! The other nurse and I just looked at each other with our eyes bugging out - and went to go recheck the temp. Sure enough, it was 88.3 rectally. We immediately got our porta-warmer and neowrap around the kid. By the time we left 20 or so min later, the temp was up to about 89-90. 45 min later when we got back to our unit the temp was up to 97. Needless to say the kid ended up w/ a bilat g3 IVH (among several other issues - is now 37 weeks, still vented.. going to be here forever...) Anyway... the scariest thing about the whole temp thing - was that the nurse who told us that the temp was 88.1 degrees said it very matter-of-factly... If I was telling somebody that a baby's temperature was 88.1 degrees I would most definately have some concern in my voice!

preemieRNkate, RN · Dec 7, 2006

I can't imagine going out on transport w/o a doc! We only do ambulance here - we're too close to the EL to do any helicopter transports. We always take a doc, and 1-2 RNs depending on how sick/little the baby is, and depending on our staffing as well. The last transport I went on was for a 25 weeker. When we ge there and start asking their RNs about vitals and stuff - we are told that the last temp 5 min ago was 88.1!!! Yes I typed that correctly, 88.1 degrees. Yikes! The other nurse and I just looked at each other with our eyes bugging out - and went to go recheck the temp. Sure enough, it was 88.3 rectally. We immediately got our porta-warmer and neowrap around the kid. By the time we left 20 or so min later, the temp was up to about 89-90. 45 min later when we got back to our unit the temp was up to 97. Needless to say the kid ended up w/ a bilat g3 IVH (among several other issues - is now 37 weeks, still vented.. going to be here forever...) Anyway... the scariest thing about the whole temp thing - was that the nurse who told us that the temp was 88.1 degrees said it very matter-of-factly... If I was telling somebody that a baby's temperature was 88.1 degrees I would most definately have some concern in my voice!

Oh yes, we've had some scary ones like that. An "estimated 24-weeker" (looked more like 22-23, mom didn't know she was pregnant, having abdominal pain, delivered in the car on the way to the ED) that the ED staff had wrapped in tinfoil, on a stretcher with heat lamps on. Baby's temp was in the 80's. That hospital has a NBN, I don't know why they didn't bring a warmer into the ED. They bagged the baby til we got there cause nobody could get a tube into her. Ripped her skin off on her chest trying to put EKG leads on (of course they were gigantic peds size ones too, no kittycat leads I guess). Baby wound up dying on DOL#3.

RainDreamer, BSN, RN · Dec 8, 2006

Wow.... you guys are so lucky to go on those transports, how fun .... I'd love to do that someday!

We don't go on any transports, Air Evac brings all of our transports to us. They're brought in from all over the state but it's usually Air Evac that brings them in ...... none of our nurses go out on the transports.

lovemyjob · Dec 8, 2006

we haved a team.

nurse clinician and an RRT go, they are in contact with the attending when they arrive and assess, and then before they leave to come back. They go ambulance, helicoptor, and fixed wing. They fly all over the state and even to some surrounding states. Our transport nurses are some of the best nurses on our unit. there are three on nights and three on days. They also do ecmo and peds transport when peds is busy. They also all do PICCs. I like the idea of knowing that I dont have to do transport. I think that it takes so much more klnowledge than what I have. I have bneen doing this for only 1.5 years and I cant imagine going on a transport!

SteveNNP, MSN, NP · Dec 9, 2006

HoHo.... Listen to this mess!

I was in charge last night...go figure, and I get a call from an ER doc about an hour away, telling me that EMS had just brought them a baby born precipitously at home. Mom thinks she's about 5 mos along .....hmmm that's about 22-23 weeks.......EMS apparently didn't have a small enough ETT, so they "intubated" with a "suction catheter" and are bagging to keep sats above 80. The doc proceeds to tell me that they can't weigh/estimate weight, or get a temp on the kid. No vitals except HR 90's. All this extremely matter-of-factly. So I motion for the transport RN to load up the transporter and notify the Neo on call. SO they head out, only to find out 15 min away from the ER that they also called another Level III outside their "jurisdiction" and they're almost there too. So the docs wrassle it out while 2 transport teams are heading to the ER. Finally the other team wins out and our team heads back...... I would have liked to see the "suction catheter' they were bagging through......

Sweeper933 · Dec 9, 2006

HoHo.... Listen to this mess!
I was in charge last night...go figure, and I get a call from an ER doc about an hour away, telling me that EMS had just brought them a baby born precipitously at home. Mom thinks she's about 5 mos along .....hmmm that's about 22-23 weeks.......EMS apparently didn't have a small enough ETT, so they "intubated" with a "suction catheter" and are bagging to keep sats above 80. The doc proceeds to tell me that they can't weigh/estimate weight, or get a temp on the kid. No vitals except HR 90's. All this extremely matter-of-factly. So I motion for the transport RN to load up the transporter and notify the Neo on call. SO they head out, only to find out 15 min away from the ER that they also called another Level III outside their "jurisdiction" and they're almost there too. So the docs wrassle it out while 2 transport teams are heading to the ER. Finally the other team wins out and our team heads back...... I would have liked to see the "suction catheter' they were bagging through......

So would I.... wow.

2curlygirls · Dec 10, 2006

This reminds me of a time I was team leader and got called to the ED for a delivery. (I got called to "room 5" so I ran to L&D room 5 to find a mom in early labor looking quite confused why there was suddenly a NICU team in her room!) EMS said babies looked "full term" but the OB who'd scanned the mom the day before said she was 20'ish weeks. When they got there, mom had two very tiny, semi-gelatinous babes with placentas still attached. There was nothing we could do as they were indeed 20 weeks. Mom said "Are they both dead now?" It was heartbreaking!

Where EMS got that they were full term, I have no idea. I guess if you add them together.........