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 transfers performed by neonatal specialist (NS) and non-neonatal specialist (NNS) teams in Western Australia (WA).

Study design
Retrospective comparison of neonatal transfers from the Kimberley and Pilbara regions (WA) to tertiary services, King Edward Memorial (perinatal) and Perth Children’s Hospital Neonatal Intensive Care Unit, in Perth (state capital, distance up to 2200 km) between January 2018 and June 2021. NS teams traveled from the tertiary to the referring center and back. NNS traveled from the referring to the tertiary center. Transport time, team composition, total unintended clinical and endotracheal tube (ETT) events were compared. Categorial data are expressed as numbers (%) and compared by χ2 test; continuous data are expressed as median (IQR) and compared by Mann-Whitney U test.

Results
During the study period, 3709 infants were transported in WA to tertiary services for escalation of care: 119 of 3709 (3.2%) from the Kimberley and Pilbara, 49 with NS and 70 with NNS teams. NNS had shorter transport times than NS teams (508 [433-610] vs 675 [610- 735] minutes; P < .0001). Neonatal nurses were on NS more than NNS teams (36/49 [73.5%] vs 6/70 [8.6%]; RR 5.08, 95% CI 3.13-8.56, P < .001). Total unintended clinical and ETT events were less in NS vs NSS teams (28/49 [57%] vs 54/70 [77%]; RR 0.66, 95% CI 0.40-0.92, P = .03) and (0/26 [0%] vs 7/23 [30%]; P = .004).

Conclusions
Although NS teams had longer transport times, there were fewer unintended clinical and ETT events. NS teams should be considered as the first choice to undertake neonatal transport.