If you’ve taken a look at the For the Littlest NICU database (shoutout to our last post here on the blog!) then you might have noted a little bit of a trend: 814 seems like a lot on paper, but on a map, man they sure are far apart! If you’re like me, it was a bit of a shock to see how bare the Midwest is; Wyoming doesn’t have a single unit! However, the distribution of capable NICUs is attributed to regional population density and birth rates, leaving some regions a little high and dry, or so you’d think. Thankfully, families experiencing consequences of these location disparities can rely on an ICU on wheels and in the sky: specialized neonatal transport!
In most birthing situations, when labor hits, mom is prepared to go to the closest hospital she can, however, some of these hospitals aren’t equipped for when baby needs extra help. Some efforts to ameliorate this problem were made when special care nurseries were founded at such smaller hospitals, but when a neonate requires more complex life support such as ECMO, brain cooling for encephalopathy or birth trauma, emergent surgery, or simply more specialized care, larger and more equipped units offer specialized transport.
In these situations, it can be scary for parents to watch their baby leave on a helicopter or ambulance – I can imagine how hard it must be to watch your newborn leave, but transport isn’t necessarily a bad thing or a scary thing! It’s best described as a sign that capable and knowledgeable people called in more capable and knowledgeable people to help them care for your baby. Typically, this transport team is an extension of a large, regional, and possibly academic medical center with a very advanced team of specialists, and as such, the faster and safer we can get baby there, the better baby will be.
These transport units can come in the form of an ICU on wheels (for most unit transfers) or even a helicopter (for more distant transfers or to bypass rugged terrain or city traffic). Onboard, there’s an incubator, monitors, ventilation, supplies, and medications, all manned by a specially trained NICU transport nurse and often a neonatal respiratory therapist. The nurse and RT can keep baby happy and stable in transit so that they can be evaluated and treated upon arrival at the NICU.
Why does it matter? Some families can’t get to a well-equipped hospital when they’re in labor and knowing that specialized transport exists should be a comfort! If mom is 150 miles from a level 4 NICU, her baby can still get there in a pinch thanks to the miracles of modern medicine! While this doesn’t eliminate location disparity, it sure does save a lot of critical babies, and for that, we can be grateful!
Sources: Cedars Sinai Neonatal Transport Program, Children’s Hospital of Richmond at VCU Neonatal Transport