Quality Assessment of Neonatal Transport performed by the Mobile Emergency Medical Services (SAMU)

Abstract

ObjectiveTo assess the quality of neonatal transport performed by the Mobile Emergency Medical Services (Serviço de Atendimento Móvel de Urgência [SAMU]). MethodsThis was a cross-sectional before-and-after observational study. The study was carried out from March to August of 2013 using a validated instrument, the Transport Risk Index of Physiologic Stability (TRIPS), to assess the characteristics of the newborn, medical and mechanical complications (equipment and ambulance), and stability of newborns before and after transport. Tests were conducted with 95% confidence level. Numerical variables are represented by measures of central tendency and dispersion. Categorical variables were compared by Fisher's exact test. In the comparison of variables between the groups, the Student's t-test was used for variables with normal distribution, Fisher exact test, when appropriate, and the Mann-Whitney test, for non-normal distribution. Results33 newborns were transported from low-risk units to neonatal intensive care units. Male gender (57.6%) and full-term gestational age (63.6%) were more prevalent. Birth weight<2,500g was found in 39.4% of newborns. Respiratory failure accounted for 42.4% of the requests. The mean transport time was 58minutes without medical or mechanical complications. The TRIPS score worsened in 15% of neonates; in this group of infants, the mean initial temperature of 36.46±0.19 decreased significantly to 36.08±0.22 (p=0.041). ConclusionThe transport performed by the SAMU was adequate for most newborns. The oscillation in body temperature was the only significant variable for the alteration in the TRIPS score.