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I have flown in a BO-105 for more than 18 years and would find it very difficult to assist a delivery during flight. My vote would be to leave the L&D nurse and return with the neonate team. Pam Adams has some very valid points and the last thing you would want to do is to deliver during flight and try to take care of a premie. This simply is not safe. Also, what policies do you have with your program and can you contact your medical control for additional support in declining? I am also interested in what happened. Thanks for raising the questions.
-------Original Message-------
Date: Sunday, August 03, 2003 12:17:36 PM
Subject: High Risk OB dilemna
Ok folks, here's a scenario for you. Your service flies a BO-105
aircraft, and has an agreement with a local OB receiving facility to
provide transport for high-risk OB patients. On these flights, you
send the aircraft with one Flight Nurse to the receiving facility to
pick up a Labor and Delivery Transport Nurse as part of your team, then
respond to the sending facility 20 minutes away (90 minutes by ground).
Upon arrival, you find a 26 week pregnant, G1P0 patient whose cervix
is dilated to 10 cm with intact but bulging membranes. She came in the
day prior with contractions which were controlled with a MagSo4 drip at
3gm/hr. She is no longer having contractions. The sending physician
wants her transferred to the receiving specialty center to manage her
pre-term labor, but does have the capability to resuscitate a preemie
newborn if necessary.
1.) Would you transport this patient?
2.) For the sake of discussison, lets stipulate that you're not
comfortable with transporting the patient, but the L&D specialty nurse
and the receiving Perinatologist feel the patient is stable enough to
transport by air, and is not in danger of delivering precipitously
enroute. Given this information, would you then transport the patient?
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