Transport

prmenrs, RN · Dec 5, 2012

@Bortaz---that's the way we did way back when! I went on the 2nd neo transport in the county ~ 1971 or so; personnel: me and the 2nd yr resident, the ambulance driver, and some other guy. We sat on the floor in the back of a Cadillac ambulance, w/the owner of the ambulance co driving. Baby was a 35 wk-ish, jaundiced baby, maybe a little septic. Oh, and Dad rode back w/us. We drove 266 mi roundtrip in ~ 4 hrs! Had to stop for gas, too. Baby did fine. Took ~ 10 years off my life, tho.

Bortaz, MSN, RN · Dec 5, 2012

Yeah, most of ours will be 1.5-3 hours roadtime round trip. I'm certainly not comfortable with it so I've "forgotten" to sign up for call so far.

FlyingScot, RN · Dec 5, 2012

I'm going to assume this kid wasn't coding then...? Because around 50% of our transports to us are and the RN is supposed to run it. Line them if needed and get kid back to our hospital alive.

50% of your transports are CODING?!!!!! What the he@# is wrong with your referral hospitals? I've been doing this a very, very long time (for Level 3 and 4 NICUs with ECMO and open hearts) and our statistics were never even close to those statistics!

NicuGal, MSN, RN · Dec 6, 2012

I can count on one hand the number if kids that were near coding or did. We had to land in a Kmart parking lot once because we had a kid code and the weather was bad. I had one that we were coding on our way and pronounced on the helipad. Bad news. I can't IMAGINE running those by myself with only the flight nurse and RT.

FlyingScot, RN · Dec 6, 2012

I can count on one hand the number if kids that were near coding or did. We had to land in a Kmart parking lot once because we had a kid code and the weather was bad. I had one that we were coding on our way and pronounced on the helipad. Bad news. I can't IMAGINE running those by myself with only the flight nurse and RT.

That's kind of what I'm thinking. I might have to use two hands but only because I've been a nurse for so long. Although I no longer transport, of the three teams I was on 2 were "nurse-lead" which meant we ran the codes even if we were still at the referral center; and we ran them with only a second team member who was either a medic or an RT. The third team was way back in the 80's and we took residents at the time (they don't any longer).

BsuBri · Jan 13, 2013

Just wondering what everyones protocol is for training to be transport. Is everyone required to do it? Is there a special team in your NICU? Thanks!

There is training.. You apply and then have an intense training... I would assume it would be specific to your department and level of your nicu

BsuBri · Jan 13, 2013

That sounds like a flawed plan! We go out with an RT and fellow we can't intubate but we can do lines and art sticks. We have training on the isolette and get checked off on helicopter and ground transport by the flight nurses and pilots. We have to go thru a life flight training for safety. We also require 2/3 years experience and have compentencies to do.[/quote']
In our nicu you have to have 2 years full time experience ...maintain 0,3 fte in the unit and attend so many deliveries in a quarter... You also have to have so many intubations and line placements.. We also go on transports with an rt and if the baby is 32 weeks and younger you take a doc

roquen · Feb 4, 2013

We have an RT, RN, EMT and an NNP for all NICU transports. RT/RN/NNP is cross trained for all procedures and competency is done during orientation which differs in length depending on transport volume and again annually for procedure labs.

RT/RN/NNP experience requirements vary but are typically 3 years of Critical Care experience along with preference to C-NPT holders and EMT experience.

The RT, RN and NNP and EMT are all assigned to transport by their own departments but when they're on shift as transport they're not in regular assignment. They act as a clinical resource to the NICU RNs and RTs, providing support and covering lunch/potty breaks.

Bortaz, MSN, RN · Feb 4, 2013

*sigh*

prmenrs, RN · Feb 4, 2013

If you're in a dedicated Childrens Hospital, the only way you get business is to transport it in. So, it behooves you to have a dedicated, fully staffed (RN, RT, NNP, EMT x2,...) Transport team on the premises @ all times, including the Ambulance. (Absolutely nothing gets your HR up like cooling your heels waiting for the "bus" :mad: ) And a second team on call. Let's not forget those fun filled Life Flights, either.

If your unit has mostly "in-born" babies, i.e, L&D is down the hall, and maybe hi-risk antepartum moms, your transport team will probably be less busy, and you'll have to pull your team together from whomever is already on duty. Minimum personnel might be a Fellow level MD, RN, RT, and EMTs (they can be very helpful!). All the RTs and most of the nurses need to be trained and competent to go out.

@Bortaz--I get the feeling you're getting pushed into this??

Bortaz, MSN, RN · Feb 4, 2013

Yeah, they'd like to, if I weren't dodging so quickly.

There is no plan, no training, no common sense being used.

prmenrs, RN · Feb 4, 2013

Sounds like "they" want to do it the hard way. The transport teams w/which I'm familiar have evolved over many years--the hair raising tales I could tell! Like trying to get the Navy or Coast Guard to take us out to the desert, the "surprises" other hospitals had waiting for us. :madface: :nailbiting: It got a lot better when we started to do outreach education @ the referring hospitals, developing ALS nurses' roles, having Neo attendings rounding @ the referring hospitals, that sort of thing.

There is NO reason whatsoever, imo, to re-invent the wheel. It may be necessary to get MORE involved, not less. (not what you want to hear, but I think you are ready, from a career standpoint, to get into the mess.)

You know I wish you the best, for yourself and your babies. Be brave!