neonatal transfer service london · pdf fileneonatal transfer service london ... curosurf 200...

Neonatal

Transfer

Service

London

NTS

Information

Pack

Neonatal

Transfer

Service

London

Preparing for NTS Transfer:

Use NTS referral form as guide for telephone referrals

Prompt verbal handover on NTS arrival

Infusions in 50 ml syringes

Time saver: NTS infusion formulae used—see overleaf

2 copies of neonatal summary

Copy of nursing & drug charts

Copy of blood results

Guthrie

2 name bands

Parents updated

Neonatal

Transfer

Service

London

Neonatal Transfer Service for London Remit & Contact Details 3

Kent, Surrey and Sussex Transfer Teams Remit & Contact

Details 4

CATS & ANTS Transfer Teams Remit & Contact Details 5

Oxford & Portsmouth Transfer Teams Remit & Contact Details 6

Clinical criteria for Time Critical Transfers & The Neonatal

Transfer Team Referral Process 7

Emergency Referral Information Needed 8

CONTENTS:

Neonatal

Transfer

Service

London

Neonatal Transfer Service for London

Emergency Transfers 0207 407 4999 (via EBS)

Area covered: Transfers within London, and originating from a London unit transferring out

of London.

24hrs—7 days a week

Increased level of care

Surgical

Specialist treatment

PDA / Cardiac

Ventilated back transfers

Elective Transfers 0203 594 0888

Area covered: London, Kent, Surrey, Sussex, East of England and any journey taking no longer

than 8 hours to complete (baby must transfer either into or out of a London unit)

Monday—Saturday 08:00-18:00

Each journey is chargeable on a time and mileage basis.

Back transfers

Outpatient appointments

Stable babies (Cpap / Nasal Cannula / Self Ventilating)

Contact Details

Transfer Services

Neonatal

Transfer

Service

London

Contact details continued

Transfer Services

Neonatal Transfer Service for Kent, Surrey & Sussex (KSS)

Emergency Transfers 0207 407 4999 (via EBS)

24hrs—7 days a week


Surgical


PDA / Cardiac

Medway Team

Area covered: Kent

01634 825125

St Peters Team

Area covered: Surrey

01932 722015

Brighton Team

Area covered: Sussex

01273 696955 Ex 4747

The three teams cross cover each other’s areas.

Elective transfers: KSS are funded to retrieve babies from London back into their area,

please contact the team covering the area the baby needs to be transferred into.

Neonatal

Transfer

Service

London


Transfer Services

Children’s Acute Transfer Service (CATS)

Emergency Transfers 0800 0850003

Emergency service 24hrs—7 days a week

Area covered: North Thames, Essex, Herts and Beds regions to a regional paediatric in-

tensive care unit (PICU) or a neonate admitted to NICU or CICU at GOSH.

Babies over 1kg admitted to NICU or CICU at GOSH


Cardiac

Surgical

ECMO

The Acute Neonatal Transfer Service (ANTS)

Emergency Transfers 01223 274 274

Area covered: East of England




Elective service from 8am to 6pm on weekdays Back transfers Specialist outpatient appointments that last up to one hour There are 2 Neonatal Transport teams operating within South Central: NeTS (Solent) and Thames Valley

Neonatal

Transfer

Service

London

Neonatal Transport Service.


Thames Valley Neonatal Transport Team

Based: Newborn Intensive Care Unit at the John Radcliffe in Oxford

Oxford Team

01865 221368

Area covered: Northern part of South Central Area; Horton Hospital in Banbury, Wexham

Park, Stoke Mandeville, Royal Berks and Milton Keynes

We operate 24/7 for emergencies .

We also transfer Cardiac Babies from Northampton and transfer any cardiac Babies to Southampton or GOS. Occasionally when Mums are booked for antenatal specialist care (from outside our region) we transfer the Babies back to their LNU as soon as they are stable.

All types of transfers are undertaken – time critical, urgent and back transfers.

Elective transfers are pre-arranged by phoning 01865 740377 ( Admin office) These are usually done between 08-2000 hours unless the cot is needed urgently to accept a criti-cal ill baby.

South Central Neonatal Transfer Service

Portsmouth Transfer Team

0239 228600 ext.3687

Based: St. Mary’s in Portsmouth.


Transfer Services

Neonatal

Transfer

Service

London

Clinical criteria for Time Critical Transfers:

(As recommended in the Department of Health Toolkit for High Quality Neonatal Service 2009 )

Gastroschisis

Ventilated infant with Tracheo-oesophageal fistula +/- atresia

Intestinal perforation

Suspected duct-dependent cardiac lesion not responding to prostin

Unstable respiratory or cardiovascular failure not responding to appropriate management:

Despite giving appropriate ventilation via endotracheal tube the infant’s respiratory status remains un-stable or severely compromised:

persistent unstable pneumothorax despite chest drain

requiring FiO2 100%

arterial oxygen < 5kPa on 2 consecutive blood gas measurements

pH <7.1 and pCO2 >9kPa

persistent mean blood pressure below corrected gestational age, measured on arterial line;

measured with cuff only, there should also be acidosis (pH <7.1)

How to refer an emergency transfer to the Neonatal Transfer Service for London

Telephone: 0207 407 4999 Emergency Bed Service (EBS)

Just one call to locate a bed and activate the emergency team.

You will speak to an EBS officer, they will take the patients demographics and some basic clinical de-

tails, they will then connect your call to a member of the transfer team if they are available or get them

to call you back, they will also locate a bed.

A copy of our referral sheet is on the next page, it would help the referral process if you have the pa-

tients demographics and clinical information listed on our referral sheet to hand when you speak to a

member of our team.

NTS Referral Form

Date of Referral: Time of Referral: Ref No: 3014 __ __ __

Contacted via EBS: Yes No EBS Operator: Conference Call: Yes No

Please tick one of the options below:

Emergency Elective Referral File sheet in diary Enquiry Once dealt with file

in Red Tray

Referring Hospital: Ward:

Contact Name: Consultant:

Telephone Number: Ex or Bleep:

Baby Details

Name: D.O.B: Birth Weight:

Gestation: Time of Birth: Current Weight:

NHS No: Day: Sex:

Date of Transfer: Team used: BT01 BT02

Team location at time of call: At base On another call Pre-booked Other :

Clinical Details

Details of referral:

Antenatal History & Delivery (brief history)

Respiratory State: Ventilated Cpap N.Cannula Oxygen SV The following info is need for the mint score:

Vent mode: Pressures: ETT Size: ETT Length: Apgars: /1min /5min /10min

I Time: Rate: Latest Gases: (A)rterial (V)enous (C)ap Congenital Abnormalities:

Fio2: Sats: Time

BM: Mean BP: Site A V C A V C A V C Lines:

Fluids: PH 1. 3.

PCo2 2. 4.

Feeding: Po2 Temperature:

Sedation & Paralysis: HC03 Antibiotics:

BE Inotropes:

Relevant Blood Results: Infection Issue: Yes No

YES PTO:

You MUST answer this question!

IS THIS TRANSFER

TIME CRITICAL?

(See overleaf for definitions)

YES NO

Advice given to referring unit: Advice followed: Yes / *No * If No provide reason

Chargeable Journey: Yes / No (charging sheet sent to LAS ) Total Time: Form completed by:

Accepting Hospital: Ward:

Transfer Cancelled: Yes No

(Reason)

Contact Name:

Consultant:

Telephone Number: Consultant on-call for NTS:

Personnel on board: Doctor/ANNP: Nurse: Paramedic:

Consultant: Observer:

Neonatal Transfer Service Drug Calculation Sheet

(This form does not replace a drug formulary)

Cardiac Drugs

Infusions

Dopamine

The usual dose of dopamine is

5-20micrograms/KG/min

Wt (KG)______ X 30=

______ mgs added to 50 mls of 0.9% Sodi-

um Chloride or 5% Dextrose.

1ml/hr will deliver

10 micrograms/KG/minute

Dobutamine

The usual dose of dobutamine is

5-20micrograms/KG/min

Wt (KG)______ X 30=

(max concentration 250mg in


um Chloride or 5% Dextrose

1ml/hr will deliver

10 micrograms/KG/minute

Adrenaline

The usual dose of adrenaline is

50-500 nanograms/KG/min

Wt (KG)______ X 3=

______ mgs added to 50 mls of 0.9% saline

or 10% Dextrose.

NB. NB. 0.1ml/hr will deliver 100nano-

grams/KG/minute

Noradrenaline

The usual dose of adrenaline is

50-500 nanograms/KG/min

Wt (KG)______ X 3=



NB. NB. 0.1ml/hr will deliver 100nano-

grams/KG/min

Dinoprostone (Prostaglandin E2) (Prostin

® E2)

The usual dose of Prostin is 5-10 nano-grams/KG/min though higher does may be used in consultation with car-

diology.

Wt (KG)______ X 15=

______ micrograms added to 50 mls of

0.9% Sodium Chloride or 5% Dextrose.

1ml/hr will deliver 5 nanograms/KG/min

Drug Dose Calculation Amount to be given

Morphine Bolus

(100mcg/KG)

Wt (KG)______ X 100 =

______ micrograms by slow iv push

Suxamethonium

2mg/KG

Note: the administration of suxametho-nium may cause profound bradycardia

requiring atropine administration

Wt (KG)______ X 2 = ______ mgs by slow iv push

Atropine Wt (KG)______ X 10= ______ micrograms by slow iv push

Curosurf

200 mgs/KG 1st Dose

100 mgs/KG 2nd

Dose

Wt (KG)______ X 200=

Wt (KG)______ X 100=

______ mgs

______ mgs

Emergency Drugs

Adrenaline 1:10 000 Wt (KG)______ X 0.1 =

______ mls iv stat

Sodium Bicarbonate Wt (KG)______ X 2 =

______ mls of 4.2% sodium bicarbonate

for use during emergency resuscitation.

(If 8.4 % is used it should be diluted ml for ml with water for injection and infused

slowly)

Adenosine

50micrograms/KG Wt (KG)______ X 50=

______ micrograms iv stat into a large central vein and followed immediately by

Sodium Chloride 0.9% push

Insulin

The usual dose of insulin starts at 0.01 Units/KG/hr and is increased or de-

creased according to response

Wt (KG)______ X 5=

______ Units added to 50 mls of 0.9% So-

dium Chloride.

0.1mls/hr will deliver

0.01 units/KG/hour

Neurology

Phenobarbitone (Loading)

20mgs/KG

Wt (KG)______ X 20 =

______ mgs by slow iv push

Phenytoin (Loading)

18mgs/KG

Wt (KG)______ X 18= ______ mgs to be given over 30 minutes

(needs close ECG monitoring)-

Clonazepam

50 micrograms/KG

Wt (KG)______ X 50= ______ micrograms

Infusions

Clonazepam

The usual dose of clonazepam is

10-40 (BNFC max 60) micrograms/KG/

hr

Wt (KG)______ X 0.5=

BNFC recommends 12mcg/ml concentration. Change syringe 12hrly – must be filtered with


um Chloride

1ml/hr will deliver

10 micrograms/KG/hr

Drug Dose Calculation Amount to be given

Sedative Drugs

Morphine Bolus

100micrograms/KG

Wt (KG)______ X 100 =

______ micrograms by slow iv push

Vecuronium

100micrograms/KG Wt (KG)______ X 100= ______ micrograms by slow iv push

Pancuronium

100micrograms/KG Wt (KG)______ X 100= ______ micrograms by slow iv push

Infusions

Morphine

The usual dose of morphine is 5-20 micrograms/KG/hr but higher doses

may be used. The maximum dose is

40 micrograms/KG/hr

Wt (KG)______ X 1=



1ml/hr will deliver

20 micrograms/KG/hr

Vecuronium

The usual dose of vecuronium is

50-200 micrograms/KG/hr

Wt (KG)______ X 5=



1ml/hr will deliver

100 micrograms/KG/hr

Neonatal

Transfer

Service

London

Neonatal Transfer Service for London

We offer observer days with our emergency

team, to arrange a day with us contact our co-

ordinator :

[email protected]

8D, Central Tower

The Royal London Hospital

Whitechapel

London

E1 1BB

Tel: 0203 594 0888

Fax: 0203 594 0578

[email protected]

neonatal transfer service london · pdf fileneonatal transfer service london ... curosurf 200...

Documents