Atendimento de Pacientes Neonatais Realizadas pelo Serviço Aeromédico: Uma Revisão Integrativa / Neonatal Patients Carried Out by Aerometric Service: An Integrative Review

Resumo: A remoção rápida e com medidas de segurança de recém-nascidos (RNs) críticos, como por exemplo, os prematuros extremos e os com malformações congênitas complexas, nascidos em centros que apresentam insuficiência de recursos para Unidades de Terapia Intensiva Neonatal (UTIs) por meio de transporte inter-hospitalar é considerada uma das recomendações do Ministério da Saúde devido sua capacidade de diminuição significativa da mortalidade neonatal por causas evitáveis. Objetivo: caracterizar o transporte neonatal através do Serviço Aeromédico Metódos: Trata–se de um estudo de revisão integrativa, com abordagem descritiva e exploratória, sobre o tema: Atendimento de Pacientes Neonatais realizadas pelo Serviço Aeromédico. Para a realização da busca na Biblioteca Virtual da saúde (BVS), foram utilizadas combinações entre as seguintes palavras-chave, consideradas descritores no DeCS: “Neonatologia”, “Resgate aéreo” e “Urgência”. Os termos foram cruzados como descritores e também como palavras do título e do resumo. A busca foi realizada no período de Junho de 2019.Resultados e discussão: A literatura o Serviço Aeromédico é utilizado principalmente entre RNs de alto risco, no qual existem indicações pré-estabelecidas e com isso possibilita a introdução de melhores abordagens. No qual é necessário a utilização de materiais e protocolos pré-estabelcidos, como também uma equipe preparada para realização dos atendimentos nos pacientes neonatais. Conclusão: Diante dessa perspectiva é possível compreender que o avanço tecnológico alinhado ao desenvolvimento de uma medicina de qualidade pode proporcionar melhores abordagens aos pacientes neonatais e com isso estabelecer uma melhor qualidade de vida e diminuição da morbimortalidade destes pacientes.Descritores: Neonatologia, Resgate aéreo, Urgência. Abstract:The rapid and safe removal of critical newborn infants (RNs), such as premature infants and those with complex congenital malformations, born in centers that have insufficient resources for Neonatal Intensive Care Units (ICUs) by means of interhospital transportation is considered one of the recommendations of the Ministry of Health due to its capacity to significantly reduce neonatal mortality from preventable causes. Objective: to characterize neonatal transport through the Aeromedical Service Metódos: This is an integrative review study, with a descriptive and exploratory approach, on the topic: Attendance of Neonatal Patients performed by the Aeromedical Service. In order to perform the search in the Virtual Health Library (VHL), we used combinations of the following keywords, considered descriptors in DeCS: "Neonatology", "Air Rescue" and "Urgency". The terms were cross-referenced as descriptors and also as title and abstract words. The search was performed in June 2019. Results and discussion: The literature the Aeromedical Service is mainly used among high risk NBs, in which there are pre-established indications and with this allows the introduction of better approaches. In which it is necessary to use pre-established materials and protocols, as well as a team prepared to perform care in neonatal patients. Conclusion: In view of this perspective, it is possible to understand that the technological advances aligned to the development of a quality medicine can provide better approaches to neonatal patients and thus establish a better quality of life and decrease of the morbimortality of these patients.Keywords: Neonatology, Air rescue, Urgency

24 Reducing vibrations to improve infant patient safety during transportation

Primary Subject area Neonatal-Perinatal Medicine Background Each year, thousands of newborns are transported by air or ground ambulance to receive specialized medical care. For neurologically immature and physiologically compromised infants, especially preterm infants, the noise and vibration exposure during transport are high despite preventative measures, and may be an important contributor to brain injury risk. Objectives To develop a new tool to investigate vibrations during neonatal transport and mitigation strategies. Design/Methods Proof of concept study including 3 steps: 1) Characterization of the vibrations during transport. Accelerometer sensors placed on different layers of the Neonatal Patient Transport System (NPTS) (neonate manikin, mattress, incubator, deck, stretcher, and vehicle floor) with a variety of ambulance on road tests performed to capture data. 2) Experimentation - A shaker table was used to develop a standardized test environment. Vibration testing was performed, with the entire NPTS mounted on the shaker table. 3) Mitigation - Shaker table tests were repeated using different configurations of mattress and harness types on manikins with different bodyweights. Results 1) Characterization: Road transport exposed the manikin’s head to vibrations that exceeded adult standards. Examining the frequency spectra of the accelerometer signals across different layers of the NPTS suggests that two interfaces, stretcher/vehicle floor and incubator/deck, may be critical for intervention to mitigate the vibrations, as they both showed the highest gains in vibration power. 2) Experimentation: Comparison between the on-road and shaker table tests showed that the shaker table was able to reproduce on-road transportation with acceptable fidelity. The shaker table setup can serve as a standardized environment to explore the impact of several NPTS design variables on vibrations transmitted to the patient. 3) Mitigations: Different mattresses were shown to influence the vibrations experienced by the manikin. The head restraint harness type showed an amplitude reduction of the peak frequency component for all experiment types and for most mattress types compared to a standard 5-point harness. Conclusion Our study demonstrated that: i) vibrations during neonatal transport can exceed adult standards; ii) acceptable fidelity simulation of road conditions can be achieved using a shaker table system; and iii) the most effective approach for vibration mitigation should consider the whole NTPS, instead of focusing solely on the isolette.

Neonatal Aeromedical Evacuation During COVID-19: An Interview With Captain Danielle James

ABSTRACT During the coronavirus-19 pandemic, limited information existed about the risks and consequences of severe acute respiratory syndrome coronavirus 2 infection associated with maternal transmission to neonates. With rapidly evolving evidence, Air Force Neonatal Intensive Care Unit nurses at U.S. Naval Hospital Okinawa, Japan, adapted their standard operating procedures to safeguard their at-risk neonatal patients. This interview describes an Air Force NICU nurse’s view of neonatal transport and nursing care during the coronavirus-19 pandemic.