Neonatal/Pediatric Transport team

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    We have formed a new neonatal/pediatric transport team in our units. It consists of an RN highly skilled in NICU and PEDS/PICU, and an RT. We have an interest in knowing how other transport teams across the nation are set up? Who goes? RN/RT? ARNP/RN? Who runs the ventilators? When we transport from our Emergency Department, an RT does not go... Just curious about the composition of other teams....
  2. 5 Comments so far...

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    Hmm. We have a primary NICU and Peds transport teams. NICU gets all babies, including those that go to the cardiac ICU, Peds gets everything else. They do not work on the units when they are on transport and most work only transport except for the RT's who go back and forth between transport and bedside. For NICU transports at least it is one or two transport RN's (depending on how sick the infant it), an RT & a paremedic. They basically have standing orders to do whatever they have to do to get kid back alive including run codes, intubate, place lines, etc. They have an MD contact to call for questions/orders if needed or if they think the baby needs to be pronounced and not transported. RN's on the team have to have at least 5 years ICU experience (NICU or PICU). This is in a children's hospital with their own free standing transport teams. Teams go via ambulance or helicopter.
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    Our hospital has separate neonatal and pediatric transport teams. The team composition is RN/RT most of the time. Staff orienting to the team will have their preceptor with them and when they're off orientation they will take a physician with them until they've completed a set number of transports and have also completed the education to be physician-less. Our RNs are in an expanded role and have the capacity to give drugs, start infusions, place lines, order x-rays and so on without physician order, although they're usually in telephone contact with the intensivist frequently as the call evolves. Our RTs are qualified to intubate and to manage ventilation. They travel by ambulance, fixed-wing or helo. Sounds like umcRN and I work on the same unit but we don't. Our transport RNs are expected to help cover breaks on the unit, perform all intrahospital transports of PICU patients, start IVs on the wards and provide rapid response to all peds patients when they're not out. That creates a fair bit of conflict.

    We also have an ECMO transport team. It consists of 2 RNs and 2 RTs (at least 2 of whom must be ECLS certified and one must be a primer), an intensivist or fellow and a surgeon. They've travelled as far as 1000 miles to cannulate and retrieve a patient.
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    My hospital has separate pediatric and neonatal teams. Each works with 1 RN and 1 RT unless things are bad and they need to take extra hands. The RTs intubate and manage the ventilators, give aersols, etc. The nurses start lines, give medications, run pressors if necessary.
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    My previous employment was with a Transport Team that did both NICU/PEDS. The team consisted of usually one RN and one RT. Both were trained to intubate just in case one was having difficulties. We transported via ground, rotor wing and fixed wing. There is no better feeling having a solid RT next to you when having to transport difficult airway kids.

    It was a very rewarding experience and I miss it terribly (wife wanted to move to a dry climate). The only thing that was annoying was when you were not on transport, you felt as if you were under a microscope by fellow RN's and staff. I always tried to be visible and helped out with breaks, start IV's, etc.
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    In Australia we have a separate service entirely that does transport of children and neonates between hospitals, particularly from small, peripheral hospitals to tertiary paediatric centres. It's called Newborn Emergency Transport Service - it's tagged as a "moving intensive care for kids". The retrieval teams are transported by helicopter and road (I don't think they do fixed wing) and are staffed by doctors and nurses (we don't have respiratory therapists in Australia) with significance experience in neonatal and paediatric critical care. They are co-ordinated by a central clinical co-ordination centre.

    Here is their website: NETS NSW


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