Re: stable neonate transports

["Wesley Copeland Sr., MICT, NREMT-P, CCEMTP" <wcemt@terraworld.net>]

Well here is an interesting piece of information to further stir the pot.
The hospital where I am based has the only NICU in the area.  Last month I
had to recert my NRP and took the class offered here.  There were aprox 15
people in the class.  Myself (a flight medic), a nurse practitioner from the
NICU, a couple of RT's from the NICU and the rest were RN's from the NICU
and L&D.  Sounds OK so far right!  During the skills stations only myself
and the Nurse Fractioned were required to perform infant intubation because
we are were the only people in the course who are authorized to intubate
infants per Hospital / NICU policies and our protocols.  (Doctors, CRNA's
and Flight Nurses are also permitted , but none were in the class.)  It
should also be noted that the RN's and RRT's received an NRP Card even
though they were not checked off on intubation..  Now then, before all the
NICU nurses get up in arms, I'm not trying to say I'm a "neonatal master",
in fact I would prefer a neonatal team transport really sick babies (and 99%
of the time they do.)  I just offer this as food for thought and to fuel the
fire of discussion.

Wesley Copeland


----- Original Message -----
From: "Robert Cole" <EMCOLERS@adaweb.net>
To: <flightmed@flightweb.com>
Sent: Monday, April 01, 2002 7:32 PM
Subject: RE: stable neonate transports


>
> I am not saying that NICU transports should be performed by inexperienced
> personnel, I am asking in very simple terms...what makes one experienced?
is
> it different if you are an RT or an RN? can those standards be applied to
a
> paramedics? Are there any standards at all? If not why not? For example,
> most flight services have a minimum requirement of 3-5 years high volume
> service, ACLS, PALS, ATLS, CCEMTP for medics and similar for RN's, are
there
> any standards for NICU teams other than locally established standards?
Are
> those standards universal across disciplines, how do they differ? I am
just
> curious, and I like to stir the proverbial pot by asking tough questions.
I
> am not trying to say medics should or should not be on NICU teams, just
> seeing what makes one a valuable member...
> Where did I get this from? well a recent conversation with a NICU nurse on
> NRP/NALS and weather paramedics should be allowed to take the class, and
> weather they could become instructors, considering the complexity (or lack
> there of) of the course content compared to ACLS and PALS (new
guidelines).
> So with this thread my little mind worked and asked the tough question:
> "what makes one qualified to do NICU transports" and "If (hypothetically)
> one was to implement non standard diciplines on the NICU transport team
> (RT's, non neonatalologist, and yes...paramedics) what would be the
> educational, clinical, and certification train up? What are the
differences
> between professions in this setting and are any differences in how the
> standards would be applied. Could a non traditional discipline provide
care
> along side a special trained nurse as a member of the team? What would it
> take?
> In short:
>
> Initials aside...what makes one competent to do NICU transports?
>
> Robert S. "Steve" Cole
> Paramedic, CCEMTP
> Education Department
> Ada County Paramedics
> 208-375-7079
> emcolers@adaweb.net
>
> "...A mind stretched with new ideas never regains its former shape"
>
>
> -----Original Message-----
> From: Mauseth Patrice [mailto:Patrice.Mauseth@HCAHealthcare.com]
> Sent: Monday, April 01, 2002 6:21 PM
> To: 'flightmed@flightweb.com'
> Subject: RE: stable neonate transports
>
>
> I don't have ANY issues with paramedics or any other health professionals.
> In California, a medic could not work in an NICU taking full care of a
baby.
> That's what I mean when I say who else would work in an NICU.  The state
has
> the final decision.  When you need a trained team, it ends up being an RN.
> We fly with an NNP and RT.
>
> I forget this is an international website.  Different countries will have
> different configurations.  Our state would not allow a medic to transport
a
> neonate without an RN.  I'm not saying that's right or wrong.  I'm saying
it
> just couldn't be done any other way.  The bottom line....  We need teams
who
> are specific to neonatal transports to move our babies.  Those teams must
> have abundant experience in the NICU.
>
> > -----Original Message-----
> > From: Ken Lawson-Williams [SMTP:Macgyver@FlightMedicMail.com]
> > Sent: Monday, April 01, 2002 4:28 PM
> > To: flightmed@flightweb.com
> > Subject: RE: stable neonate transports
> >
> > --- Mauseth Patrice <Patrice.Mauseth@HCAHealthcare.com> wrote:
> > >What other title could work in an NICU?
> >
> > FP-C, CCEMT-P, NREMT-P, REMT-P etc.
> >
> > Other than politics, what reasons are there for not having paramedics
> > assigned to and working in an NICU? In British Columbia, all the
neonatal
> > transports are done using paramedics who spend one tour on the aircraft
> > and the nect in the NICU. Has been working well for years. No nurses or
> > RT's, and only occasionally a doctor (neonatologist, not a resident) -
> > based on patient instability, but always two paramedics.
> >
> > >It is vital to have NICU experience.  Not just a few classes and
> > >precepting with the patient type.
> >
> > Completely agtree. See above.
> >
> > Fly Safe. KLW
> >
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