My First Transport

  1. Was a comedy of errors...Went to pick up a 34 weeker with RDS, intubated but very stable. As soon as we got in the rig and on the road, babe extubated herself. Then we got stuck in traffic (it's Sat. evening) due to an "officer related shooting" that had us seriously contemplating going code three just so we could MOVE! Anyway, we ended up bagging baby for half an hour until she decided all she needed was some CPAP. She could have stayed at the referring hospital for that! It was actually kinda fun despite all the unexpected excitement. That's why I love this job!!!
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  2. 21 Comments

  3. by   prmenrs
    Sounds to me like you did a great job.

    I went on the 2nd transport ever done in this area. Me and a 2nd year resident in the back of Cadillac ambulance--the old fashioned kind that was ~ the size of a station wagon. I had to sit on the floor of the thing to be next to the baby. The baby was a r/o sepsis that was just a little small; Dad rode back w/us. Never happen these days! Baby never turned a hair until we had to stop for gas--he didn't like that! The owner of the ambulance service drove. We left San Diego @~2am, drove to Brawley, took 1/2 hour to assess and pick up the baby, and were unloading the ambulance back in San Diego @ 6:30am. It's 180mi to Brawley. You do the math--how fast was that guy going??

    Another transport to Brawley a couple years later was for a Bili baby, again, not that sick. I think there must have been a peds in town that would refer for a transport rather than get out of bed! By then, we'd graduated to a van. (I wasn't on that one) About 1/2 hr out of Brawley, the kid decides he's hungry--really hungry. That's right. No formula in the transport box. The resident on that trip asks the driver to turn the lights out and pretty soon, the rest of the team hears loud and vigorous sucking. The resident was still lactating from having her own baby, and hearing the baby cry made her let down, so.....

    Ah, the "good ol' days"!!!
  4. by   preemieRNkate
    We go out on transports quite often to a community hospital with a level I nursery, alot of times for a TTN kid. It's amazing how the hour long ambluance ride "cures" them! I like transport, I used to ride as an EMT and I find the occasional field trip kind of fun. I'm starting a new job next month, and the NICU staff doesn't go out on transport, I think I'm going to miss it.
  5. by   Zippedodah
    Ah, the first transport...thankfully we go by air for most of ours! When we do go by ground, we go "hot" so we don't get stuck anywhere. We always go with RT and a fellow, so if that babe had extubated for us, we would have pulled over and retubed.

    My first transport was for a 24 weeker at a hospital we all cringe over....got there and Baby was tubed to the 9 mark EEKKKKK had a pneumo, gee whiz, and was on an unheated RW. Gads. Of course you can't say, What is wrong with you!, so you do damage control, hope the kid is gonna live, say bye to parents and get going. Now at least, most of the hospitals that we go to have NRP and STABLE, and thank god we have a full team with us!
  6. by   SteveNNP
    I can't wait to do it too! I have to wait til next June to start training to transport. Hopefully both helo and ambulance. I've gotta learn umbilical line insertion, art sticks, intubation, train with the helo team, etc. It's gonna be awesome. It's what I've been waiting what seems like forever to do!

    Stevern21
  7. by   Gompers
    This thread has sparked some curiosity on my end...

    How many of your hospitals send doctors on transport and how many don't?

    We never go anywhere without a doctor. If it's a stable kid being transported for something like hyperbili, the resident can go. If the kid is sick, a fellow or attending must be there. We also send an RN every time, of course, and if the baby is on anything other than room air, one of our NICU RT's as well.

    We don't have a special transport team. We all train to do it after working on the unit for about a year, unless we have a medical excuse forbidding it. Everyone does ambulence transports, but you can choose whether or not to take the class for helicoptor trips. If you're assigned to admit that night and the next admission is a transport rather than from an in-hospital delivery, then you're going on a field trip! Kind of makes it fun, though - you never quite know when you'll be going and it definitely mixes things up and makes the shift fly by.
  8. by   Zippedodah
    Ours is voluntary....I only go by air now since I have a habit of becoming very sick in the ambulance. We have criteria...have to be a staff nurse for 2 years, have NRP/STABLE, experience in going to deliveries with our NNP's, be able to do art sticks, lines, pass the math test (since we mix our own meds, drips, etc on the field), pass with the pilots (be able to do everything the flight nurses do in an emergency such as get the doors off, etc).

    We always send a fellow, a NICU RN, an RT and if by air the flight nurse. No exceptions.

    I don't see how they can MAKE you do transport, that is a call above duty...some people won't do it because they are single mom/dad and if they are in an accident there won't be anyone there for their child. Others just plain are afraid to and others just don't want to. We had a lot of people drop out after the helicopter crash at a hospital here and more after one of our rigs got hit when they had to pull over.
  9. by   preemieRNkate
    Quote from Gompers
    This thread has sparked some curiosity on my end...

    How many of your hospitals send doctors on transport and how many don't?

    We never go anywhere without a doctor. If it's a stable kid being transported for something like hyperbili, the resident can go. If the kid is sick, a fellow or attending must be there. We also send an RN every time, of course, and if the baby is on anything other than room air, one of our NICU RT's as well.

    We don't have a special transport team. We all train to do it after working on the unit for about a year, unless we have a medical excuse forbidding it. Everyone does ambulence transports, but you can choose whether or not to take the class for helicoptor trips. If you're assigned to admit that night and the next admission is a transport rather than from an in-hospital delivery, then you're going on a field trip! Kind of makes it fun, though - you never quite know when you'll be going and it definitely mixes things up and makes the shift fly by.
    Everyone is supposed to be transport trained after working on the unit for about a year or two. You have to be ok to go to the DR on your own (with a doc or a NNP), have NRP, be competent with art sticks and IV's to start training. We have people who have been working for 5 or more years that are still not transport trained though, they've just managed to avoid it.

    We typically go out with the NNP, a RT, the NICU RN and an EMT that drives the ambulance. Occasionally if the unit is super busy, the peds transport resident on-call will go instead of the NNP (would much rather go with the NNP though!!) or if it's twins both the NNP and resident go.

    We only go by ambulance (boring!). Hospitals here are so close to each other that you can get wherever you're going in about an hour or less. I think one time they flew the team out to a hospital that is about 50 miles away (that doesn't have L&D or nursery) and the ambluance met them there. By the time they got the kid stablized, the ambulance was there and ready to drive them back.

    I personally really like transport. I'm confident going with the NNP, because all the ones I work with are great. It makes the night go fast, and I kind of like checking out other hospitals. I think I'm going to really miss it at my new job.
  10. by   SteveNNP
    In my unit, you can "electively" train to transport after 2 years of level III experience. Transport nurses have to be checked off on Art sticks, intubation, unbilical line insertion, etc, and take flight/ambulance orientation classes. The Neos never go, unless maybe it's a sick, sick kid on iNO/vent. We don't have NNP's, or residents.
  11. by   JeanettePNP
    Quote from prmenrs
    The resident on that trip asks the driver to turn the lights out and pretty soon, the rest of the team hears loud and vigorous sucking. The resident was still lactating from having her own baby, and hearing the baby cry made her let down, so.....
    That's so sweet! Have you ever/would you ever nurse someone else's baby?
  12. by   prmenrs
    I have not lactated (I adopted my son), but I probably would if I were in a similar situation.

    Once she started letting down, I'm sure she would have been soaked if she hadn't nursed the baby. Her baby was a few months old, and she had LOTS of milk!!
  13. by   JeanettePNP
    Quote from prmenrs
    I have not lactated (I adopted my son), but I probably would if I were in a similar situation.

    Once she started letting down, I'm sure she would have been soaked if she hadn't nursed the baby. Her baby was a few months old, and she had LOTS of milk!!
    That was lucky, then. But wouldn't it be hard to get a baby to latch on to a strange woman?
  14. by   prmenrs
    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.

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