Study on Neonatal Transport at Tertiary Care Centre

Transporting of neonates is the greatest challenge faced today in the outcome of neonates in our country. We have scarce and inaccessible facilities, no any accomplice for enroute and underdeveloped communication system. Many babies thus transported are cold, blue and hypoglycaemic. This study aims to study the impact of epidemiological factors related to transferred neonates, adverse events related to transferred neonates, role of TOPS score and outcome. Study included all neonates less than 7 day of life. Total 300 neonates were randomly selected and enrolled in the study. Study was questionnaire based, the receiving clinician documented the routine clinical physiological parameters as observed on arrival of the baby on data capturing sheet developrd by the researcher. TOPS scoring was done on arrival ( temperature by digital thermometer in axilla, SPO2 by pulse oximeter, CRT in mid sternum region, RBS by reagent stip). Out of 300 enrolled, 47.3 % were transported in ambulance, 33 % in autorickshaw, 18.3 % in open vehicle; 55.7 % were accompanied by un trained relatives, 15 % by doctor or nurse, 28 % paramedical person; pre transport stabilisation done only in 37.6 %, referral hospital informed prior to transport only in 28 %. Reason for transport (21.4 % preterm, 16.4 % birth asphyxia, 13.7 % septicaemia, 11.3 % meconium, 9.6 % ventilator support, RDS 9.3 %, LBW 6 %). Altered parameters (hypothermic 55 %, hypoxic 27.4 %, hypoperfused 23.4 %, hypoglycaemic 20.6 %). TOPS score ( one 40.3 %, two 16 %, three 12.4 %, four 4.3 %), 23.7 % expired (septicaemia 46.4 %, birth asphyxia 18.3 %, meconium aspiration 15.5 %). This study demonstrates current prevailing situation in the country, a significant number of neonatal deaths can be reduced by early identification and appropriate pre referral stabilisation, communication regarding care of newborn during transport and adequate equipment and man power at referral facility.