History and challenges of neonatal emergency transport services (NETS)

Abstract

History of neonatal emergency transport services Services for neonatal transport have evolved alongside in-hospital services for neonatal care. Early portable incubators were used to transport infants to hospitals that were designated to provide neonatal care, from either home or maternity hospitals. The treatments offered during transfer were limited to thermal support and supplemental oxygen, although interestingly early reports acknowledged the need for accompanying staff (invariably nurses) to have expertise in handling sick infants and administering emergency treatment while in transit. The development of specialized neonatal intensive care units (NICUs) providing an evolving “package” of care began in North America , Europe, and Australia in the late 1960s . Regionalization of care that paralleled the establishment of tertiary centers influenced the pattern of infants transported, with increases in the number of in-utero transfers, particularly in North America. The majority of these are for fetal rather than maternal reasons. It is as yet uncertain whether the more recent development of formal neonatal networks in other countries such as the UK will have similar effects on the profile of postnatal transfers. What is clear, however, is that neonatal transport services will remain an essential component of perinatal care. In 1966, the first newborn with respiratory distress syndrome was transported to University of California San Francisco by its NICU staff, and the first recorded transport of a mother in preterm labor from another city was undertaken in 1969. Several other centers such as Phoenix, Utah, Wisconsin, and Toronto were instrumental in developing transport opportunities for newborn infants.