Determination of transport conditions of newborns that was referred to our unit

Aim: To analyze transport conditions and management strategies of newborns that was referred to our unit.Material and methods: This prospective study was performed to newborns that was referred to Karadeniz Technical University, Faculty of Medicine; Farabi Hospital between January and December 2007 by filling out the forms.Results: We were asked for to receive 316 newborns during the study period; and 11.7% of these newborns (n=37) were died prior to transport in their initial admission medical center. 154 of these newborns (49%) were accepted. The study group was consisted of 216 newborns; 154 that were previously informed and 62 that were not informed. 104 (48.5%) of them were female, and 112 (51.5%) were male, and 93 (43%) were premature and 123 (58%) were mature. Indications for the transport was prematurity and/or mechanical ventilation support (71.4%) in previously informed newborns, while neonatal hyperbilirubinemia and infections and respiratory problems (9.7%) in not-informed group. Ambulance and transport incubator with a medical person was used for the transfer in 69% of the newborns. Epicrisis was sent in 71% (n=154) with the patient, consisted of all previously informed newborns; but inappropriate in majority of them. Diagnostic mistake was commonly made in newborns with respiratory problems. The most common therapy error was prophylactic antibiotic use. 57% of the newborns had acidosis (p<7.34), 16% had cyanosis, 15% had inappropriate respiratory support, 12% had hypoglycemia, 8% had hypothermia, bradycardia or hypotension. During transportation; most of the patients did not have intravenous fluid and/or had inappropriate fluid. 144 of these patients were discharged from hospital in good condition while 37 had organ sequel. 27 of them were died and 4 of them were exitus during transport. Three patients were referred to another center for their cardiac problems and one patient was transferred to pediatric surgery unit for esophageal atresia.Conclusion: These results show that there much patients that over capacity of our unit, and inadequate of stabilization of the patients before and during transportation, lack of communication between the centers, lack of sufficient patient information, inadequate education of medical staff and inadequate technical equipment and tools in ambulance during the transportation. Each region should create a communication network, a regional transportation teams. Unnecessary referrals must be prevented, and legal arrangements should be made for back transport system. Neonatal care unit that currently serving in our region have not meet of necessities; therefore, new neonatal intensive care units and neonatal specialists are needed.