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 ©Copyright
 Published: 29/11/2011

Transport

Welcome to the National Women’s Neonatal Flight Transport Team. In association with Airworks and St Johns Ambulance Service we are dedicated expert nurses who provide care in the aviation environment both national and internationally.

Requirements for Members

  • Level III Competency Nurse, or working towards Level III.
  • Has completed the Neonatal Nursing Course or equivalent.
  • Is experienced in road transport.
  • Is prepared to participate as an active member of the team.
  • Has passed the assessment criteria for knowledge/skills for flight transports.
  • Is on the ‘IV Cannulation’ Register.
  • Has a commitment to attending the monthly debriefing meetings.

Nursing Transport Co-ordinator -

Shirley Peachey

Equipment

We currently have three sets of transport equipment – one system dedicated to flight transports and two systems dedicated to road transports.

We currently use a Cavitron Biomed Ventilator. Being gas driven it does not alter pressure settings at altitude. We also have the facility to do Hudson CPAP and Nitric Oxide.

Why have a Dedicated Transport Team?

Basic Principles of Transport

The level of expertise of the transport team must be equivalent to the level of care provided by the receiving hospital.

The aviation environment can produce complicated physiological changes in the compromised neonate, which can result in significant deterioration of the infant's condition. For example PPHN, Meconium Aspiration Syndrome, Diaphragmatic Hernia, Pneumonia, Gastroschisis, Extreme Prematurity, etc, if not transported by clinicians experienced in neonatal intensive care with a detailed knowledge of the aviation environment, the condition of the infant and their outcome will be severely compromised.

In these times of ‘litigation’ and threats of, it is essential that nurses work within their area of expertise and not beyond their own scope of practise.

As part of the Professional Development for our flight team we ensure each member has:

  • Extensive experience in neonatal intensive care.
  • Been educated in the physiology of altitude.
  • Understands the stressors of transport as they relate to the neonate, themselves and the equipment being used.
  • A thorough understanding of the safety aspects of the aviation environment, including both helicopter and fixed winged aircraft, to ensure a greater chance of survival if an accident occurs.

Flight Transport is about safety - safety of the infant, the staff and the environment. Complacency and a blasé attitude towards safety issues can lead to disaster and death.

Transporting an adult is vastly different from transporting a neonate.  The environment is the same but the effects on the individual are quite different.

A newborn infant does not have the compensatory mechanisms of an adult. Basic physiological differences of temperature control can propel the neonate into a downward spiral of disaster if not understood.

Medications and drug dosages are vastly different, we often find that adult nurses are not confident handling and checking the small volumes that we administer.

Every baby transported has the capacity to revert back to fetal circulation, with resulting development of pulmonary hypertension, if not treated appropriately during transport. The severity of this concept is often not grasped by adult nurses. This is frequently illustrated by outlying hospitals sending us infants who arrive cold, hypoglycaemic with an increasing oxygen requirement. The basic principles of assessment and stabilisation have been overlooked because their importance is not appreciated.

In this age of ever-increasing technology and with the birth of infants at earlier gestations, it is paramount that, as a base hospital and a centre of excellence, we provide and continue to provide highly qualified transport team. A team who are able to transfer the intensive care environment from the safety of the hospital setting to the aviation setting.

Competency Updates for National Women’s , Theory and Practical Sessions Include:

  • Aviation Physiology and the Stress of Flight
  • Ethical and Legal Issues
  • Cardiac Physiology
  • Thermoregulation
  • Hypoxic Ischaemic Encephalopathy
  • Assessment Tool
  • PPHN and NO
  • Neurologically Compromised Infant
  • Team Dynamics
  • Water Safety & Survival Skills

Our team are encouraged to be members of the NZ Flight Nurses Association. Our objective is to have all members flight certified having satisfactorily completed the NZ Flight Nurses Course.

Flight Team Co-ordinator, Shirley Peachey can be contacted by email.