Rethinking the neonatal transport ground ambulance

Carlo Bellini,Martina De Biasi,Silvia Pericu,Diego Minghetti,Martina Cavalieri,Niccolò Casiddu,Roberto Aufieri,Maurizio Gente,Luca A Ramenghi

doi:10.1186/s13052-019-0686-y

Abstract

ObjectivesThis article describes the detailed project aimed to realize a dedicated ground ambulance for neonatal emergency transport service (NETS). To date, the European Community rules specify requirements for the design, testing, performance, and equipping of road ambulance used for transport and care of adult injured or ill patients, completely ignoring neonatal transport.MethodsThe project consisted of electric and gas supply planning, interior design taking into account ergonomic and occupant protection principles, both during travel and during medical care performances.ResultsA detailed project is presented. Main differences between European Type C ambulance and the new proposed Type D neonatal ground ambulance are the presence on board of air compressed cylinder, iNO cylinders and delivery system, phototheraphy, shock adsorbing stretcher support, cooling device, patient’s placenta (refrigeration box), and transcutaneous gas analyzer.ConclusionThe European Community rules specify requirements for road ambulance used for transport and care of adult injured or ill patients, completely ignoring neonatal transport.This study describes the detailed project aimed to realize a dedicated ground ambulance for neonatal emergency transport service. This study demonstrated that it is not possible simply to adapt the currently dedicated ambulance for mobile intensive care and resuscitation services (actual type C European Community) in a modern dedicated NETS ambulance; it is of paramount importance suggesting to European Community to introduce a further ambulance type, to be identified type D, strictly reserved to neonatal transport activities.

Highlights

The document EN 1789:2007 + A2:2014 ([1], see cross references inside) is issued by the European Union (EU) and specifies requirements for the design, testing, performance, and equipping of road ambulance used for transport and care of injured or ill patients, including requirements for the patient’s compartment
The aim of this article is to suggest a project to realize a dedicated ground ambulance for the neonatal transport, which function must be strictly linked to the onboard presence of a neonatal transport incubator which is designed and manufactured for specific purposes; to modify the type C ambulance design and suggesting to introduce the lacking European Union type D ground ambulance, eventually to dedicate exclusively to neonatal transport services
We believe that a strong point of our study is that we did not modify the EU type C ambulance for using it in neonatal transport activities, but, we designed the completely new EU type D ambulance previously not reported by EU documents

Summary

Introduction

The document EN 1789:2007 + A2:2014 ([1], see cross references inside) is issued by the European Union (EU) and specifies requirements for the design, testing, performance, and equipping of road ambulance used for transport and care of injured or ill patients, including requirements for the patient’s compartment. The described standards is applicable to road ambulances transporting at least one patient on a single stretcher and it is periodically revised, the most recent version being KKK-1822-F. Surprising, these two documents focused on items in order to improve fixation, interchangeability and interoperability of the transport incubator using different ambulances and aircrafts, but excluded suggestions on standards for stretchers, vehicles or medical devices. The aim of this article is to suggest a project to realize a dedicated ground ambulance for the neonatal transport, which function must be strictly linked to the onboard presence of a neonatal transport incubator which is designed and manufactured for specific purposes; to modify the type C ambulance design and suggesting to introduce the lacking European Union type D ground ambulance, eventually to dedicate exclusively to neonatal transport services

Objectives

Methods

Discussion

Conclusion