Unintended events in long-distance neonatal interhospital transport in Western Australia: A comparison of neonatal specialist and non-neonatal specialist transport teams

Objective To compare unintended events in transport performed by neonatal specialist (NS) and non-neonatal specialist (NNS) teams in Western Australia (WA). Study design: Retrospective comparison of neonatal transports from the Kimberley and Pilbara regions (WA) to tertiary services, King Edward Memorial (perinatal) and Perth Children’s Hospital NICU, in Perth (state capital, distance up to 2200km) between January 2018 - June 2021. NS teams travelled from the tertiary to the referring center and back. NNS travelled from the referring to the tertiary center. Transport time, team composition, total unintended clinical, endotracheal tube (ETT), and logistic events were compared. Categorial data are expressed as numbers (%) and compared by chi-squared test; continuous data are expressed as median (interquartile range) and compared by Mann-Whitney U test. Results During the study period, 3,709 infants were transported in WA to tertiary services for escalation of care: 119(3.2%) from the Kimberley and Pilbara, 49 with NS and 70 with NNS teams. NNS had shorter transport times than NS teams (508(435 – 609) vs 871(615 – 735) min; p<0.00001). Neonatal nurses were on NS more than NNS teams (36/49(73.5%) vs 6/70(9%); p<0.001). Total unintended clinical and ETT events were less in NS vs. NSS teams (28/49(57%) vs. 54/70(77%); p=0.02) and (0/26(0%) vs. 7/23(30%); p=0.004). Unintended logistic events were greater involving NS than NNS teams (31/49 (63%) vs. 33/70 (47%); p=0.05). Conclusion Although NS teams had longer transport times and more unintended logistic events, there were fewer unintended clinical and ETT events. NS teams should be considered as the first choice to undertake neonatal transport.