Status of Neonatal Transport and Impact of Facilitated Referral on the Outcome of Transported Sick Newborns: At Tertiary Care Hospital.
Journal Title: Scholars Journal of Applied Medical Sciences - Year 2017, Vol 5, Issue 10
Abstract
Abstract: Transport of sick newborns in India is still at a premature stage. Ineffective transport results in complications like hypoglycemia, hypothermia and hypoxia which adversely affect the outcome of transported neonates. Facilitated referral in the form of pre referral stabilization, providing written referral slip and proper care during transport can improve the survival rate of referred babies. Hence this study was undertaken to evaluate the status of neonatal transport in this area. This prospective observational study was conducted on all extramural cases less than or equal to 7 days of age admitted at the NICU of department of pediatrics, Government General Hospital, Kakinada from May 2015 to October 2016. Referral and Transport details such as place of referral, type of referral (verbal or written), details of pre referral treatment , mode of transport, duration of transport , personnel accompanying during transport and treatment given, if any during transport were noted. TOPS score was recorded at admission and all cases were followed till discharge or death. Out of 1522 transported babies, 39.2% of newborns were admitted within 24 hours of life. Preterms accounted for 46.9% and 59.2% were low birth weight. 37.8% referrals were from SNCU/district hospitals and doctor was the referring person in 76.3%. Pre referral stabilization was done in 89% of SNCU referrals and 36% of non-SNCU referrals. Warmth care during transport was provided in 68.2% cases transported in ambulance whereas it was only 33.6% in non-ambulance transport. Hypothermia was noted in 48.5% newborns. Incidence of hypothermia was higher in non-SNCU referral babies (52.9%) and in those with transport time >3hours (87%) and in babies with non-ambulance transport (87.8%). Mortality was higher in babies with 3 or more abnormal parameters of TOPS at admission. Organized neonatal transport aids for better survival of sick transported newborns. Keywords:Transport, Referral, 108 ambulances, TOPS, Hypothermia.
Authors and Affiliations
D. Manikyamba, N. Madhavi, M. Srinivasa Reddy
Keywords
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