Survey of the present status of emergency transport of newborns in the mainland of China

Abstract

Objective To investigate the present situation of emergency transport of newborns in the mainland of China in order to understand the fully utilization of good medical resources.Methods Data collected in 2009 by questionnaires from neonatal subspecialty of 109 hospitals in 22 cities across whole country about transport of newborns referred to other hospitals with better facilities,higher technology,bigger bed capacities and well qualified pediatricians were analyzed.Results The average number of neonatal beds in 109 hospitals was 35.95 (ranging from 6 to 300,median 30).Total 139 084 infants were treated in 109 hospitals in 2008,with the average number of 1276 (ranging from 32 to 5500,median 1160).Of 109 hospitals,62 (56.9％) hospitals provided transport service.The longest distance of transport varied among different hospitals ranged from 5 km to 800 km.The initiation of transport service was launched out in 1987,but 45 hospitals (72.6％) lagged behind in offering transport service until later after 2000.Of those hospitals providing transport service,35 (56.5％) were equipped with transport incubator,50 (80.7％) with neonatal transport vehicle,61 (98.4％) with telephones exclusive for transport call,46 (74.2％) with procedure of good pre-transport assessment,and 28 (45.2％) with bidirectional transportation.The main diseases admitted into were premature birth,neonatal asphyxia and respiratory distress syndrome,and the diseases for transport out were congenital malformation and congenital heart disease needed surgical intervention,and severe respiratory failure.The essential care measures for newborns during transport were keeping body warm,supplying oxygen,and intubation and CPR just in case.Data from 54 hospitals showed the average number of transport was 330 in 2008,and the largest number reached 5130 infants in a hospital.The total mortality during transport was 0.39‰.The mean rate of transport of infants of 50 hospitals accounted for 20.28％ of total admissions.Hospitals carried out transport service were significantly better in facilities and techonology than those without transport service.Conclusions Transport service for newborns has developed quickly in new millennium in the mainland China,but there are still many shortcomings called for improvement,including transport equipments,modality of transport,development of technology and optimization of regional medical hierarchy system for transfer of newborns referred from primary hospital to secondary one and further to tertiary hospital. Key words: Newborns ; Transport ; Neonatal intensive care ; Survey