Neonatal Transport in the Practice of the Crews of the Polish Medical Air Rescue: A Retrospective Analysis
Abstract
:1. Introduction
2. Materials and Methods
2.1. Study Design
- NACA 0—no body injuries or illnesses;
- NACA 1—body injuries or illnesses in case of which medical care is not necessary;
- NACA 2—body injuries or illnesses that require examination and treatment, but with no need of hospitalization;
- NACA 3—body injuries or illnesses with no acute life threat but requiring hospitalization;
- NACA 4—body injuries or illnesses that may lead to deterioration of vital signs;
- NACA 5—body injuries or illnesses posing a great threat to life;
- NACA 6—body injuries or illnesses leading to sudden cardiopulmonary arrest;
2.2. Statistical Analysis
3. Results
4. Discussion
5. Conclusions
Author Contributions
Funding
Conflicts of Interest
References
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Variable | Total | Classification of Patient Based on the Date of Delivery | p-Value | |
---|---|---|---|---|
Preterm Infant | Full-Term Newborn | |||
Sex—n (%) | ||||
Female | 196 (44.95) | 93 (47.45) | 103 (52.55) | 0.4403 |
Male | 240 (55.05) | 105 (43.75) | 135 (56.25) | |
Patient classification based on the date of delivery—n (%) | ||||
Preterm infant | 198 (45.41) | - | - | - |
Full-term newborn | 238 (54.59) | - | - | |
Age during transport (days)—M (SD) | 37.53 (43.53) | 50.40 (44.49) | 26.82 (39.73) | 0.0000 |
Body weight during transport (g)—M (SD) | 3121.18 (802.64) | 2609.07 (702.68) | 3547.24 (608.78) | 0.0000 |
Diagnosis based on ICD classification 10—n (%) | ||||
Congenital heart malformations | 180 (41.28) | 68 (34.34) | 112 (47.06) | 0.0270 |
Congenital malformations of the circulatory system | 85 (19.50) | 43 (21.72) | 42 (17.65) | |
Congenital malformations of the gastrointestinal system | 60 (13.76) | 34 (17.17) | 26 (10.92) | |
Respiratory disorders originating in the perinatal period | 41 (9.40) | 21 (10.61) | 20 (8.40) | |
Congenital malformations of the nervous system | 18 (4.13) | 12 (6.06) | 6 (2.52) | |
Congenital malformations affecting multiple systems | 15 (3.44) | 4 (2.02) | 11 (4.62) | |
Other diagnoses | 37 (8.49) | 16 (8.08) | 21 (8.82) | |
State of consciousness—n (%) | ||||
Conscious | 319 (73.17) | 142 (71.82) | 177 (74.37) | 0.5337 |
Sedation | 117 (26.83) | 56 (28.28) | 61 (25.63) | |
Skin coloring—n (%) | ||||
Normal | 353 (80.96) | 164 (82.83) | 189 (79.41) | 0.3415 |
Pale | 40 (9.17) | 19 (9.60) | 21 (8.82) | |
Yellowish | 43 (9.86) | 15 (7.58) | 28 (11.76) | |
Cyanosis—n (%) | ||||
Yes | 44 (10.09) | 23 (11.62) | 21 (8.82) | 0.3351 |
No | 392 (89.91) | 175 (88.38) | 217 (91.18) | |
Respiratory effort—n (%) | ||||
Present | 52 (11.93) | 23 (11.62) | 29 (12.18) | 0.6889 |
No | 341 (78.21) | 158 (79.80) | 183 (76.89) | |
Apnea | 43 (9.86) | 17 (8.59) | 26 (10.92) | |
Breath count (breaths per minute)—M (SD) | 36.36 (16.95) | 36.26 (16.03) | 36.44 (17.71) | 0.7738 |
Saturation (%)—M (SD) | 93.55 (6.49) | 93.99 (6.36) | 93.18 (6.59) | 0.1296 |
Heart rate (beats per minute)—M (SD) | 141.86 (17.27) | 141.18 (16.94) | 142.44 (17.55) | 0.9016 |
Systolic pressure (mmHg)—M (SD) | 76.60 (14.56) | 75.36 (13.33) | 77.63 (15.46) | 0.2056 |
Diastolic pressure (mmHg)—M (SD) | 45.23 (10.62) | 44.46 (9.58) | 45.87 (11.39) | 0.3549 |
NACA—M (SD) | 3.66 (0.80) | 3.57 (0.80) | 3.74 (0.79) | 0.0228 |
* Medical Emergency Procedures—n (%) | ||||
Oxygen therapy | 65 (14.91) | 35 (17.68) | 30 (12.61) | 0.1388 |
Mechanical ventilation—respirator | 75 (17.20) | 34 (17.17) | 41 (17.23) | 0.9879 |
Intubation | 119 (27.29) | 55 (27.78) | 64 (26.89) | 0.8360 |
** Medications during transport—n (%) | ||||
Antibiotics | 131 (30.05) | 55 (27.78) | 76 (31.93) | 0.3461 |
Prostaglandin E1 | 144 (33.03) | 41 (20.71) | 103 (43.28) | 0.0000 |
Glucose | 192 (44.04) | 99 (50 00) | 93 (39.08) | 0.0222 |
Furosemide | 63 (14.45) | 20 (10.10) | 43 (18.07) | 0.0185 |
Vitamins | 78 (17.89) | 50 (25.25) | 28 (11.76) | 0.0003 |
Parenteral nutrition | 60 (13.76) | 31 (15.66) | 29 (12.18) | 0.2948 |
Type of Aircraft—n (%) | |
Helicopter | 67 (15.37) |
Airplane | 369 (84.63) |
Type of mission—n (%) | |
Rescue transport | 90 (20.64) |
Medical transport | 346 (79.36) |
Season of the year—n (%) | |
Spring | 126 (28.90) |
Summer | 110 (25.23) |
Autumn | 103 (23.62) |
Winter | 97 (22.25) |
Days of transport—n (%) | |
Weekdays | 381 (87.39) |
Weekend | 55 (12.61) |
Referral level of target hospital—n (%) | |
II level | 95 (21.79) |
III level | 341 (78.21) |
Accompanying person during transport—n (%) | |
Parent | 186 (42.66) |
No accompanying person | 250 (57.34) |
Time of transport (min)—M (SD) | 49.92 (27.70) |
Time from taking care of patient to patient transfer to target hospital (min)—M (SD) | 86.29 (33.57) |
Time from receipt of call to patient transfer (min)—M (SD) | 269.16 (118.55) |
Distance (km)—M (SD) | 304.27 (93.05) |
Variable | Classification of Patients Based on due Date | p-Value | |
---|---|---|---|
Preterm Infant | Full-Term Newborn | ||
Type of mission—n (%) | |||
Rescue transport | 29 (14.65) | 61 (25.63) | 0.0048 |
Medical transport | 169 (85.35) | 177 (74.37) | |
Referral level of target hospital—n (%) | |||
II level | 40 (20.20) | 55 (23.11) | 0.4641 |
III level | 158 (79.80) | 183 (76.89) | |
Accompanying person during transport—n (%) | |||
Parent | 72 (36.36) | 114 (47.90) | 0.0153 |
No accompanying person | 126 (63.64) | 121 (50.84) | |
Time of transport—M (SD) | 51.07 (27.87) | 48.97 (27.59) | 0.1950 |
Time of taking care of patient—M (SD) | 86.10 (31.69) | 86.45 (35.12) | 0.2660 |
Time from receipt of call to patient transfer—M (SD) | 258.58 (108.74) | 278.07 (125.77) | 0.1231 |
Distance—M (SD) | 306.40 (94.18) | 302.51 (92.28) | 0.8150 |
Diagnosis—n (%) | Classification of Patient Based on the Date of Delivery | Sex | ||||||
---|---|---|---|---|---|---|---|---|
Preterm Infant | Full-Term Newborn | Odds Ratio (OR) | 95% CI | Female | Male | OR | 95% CI | |
Congenital heart malformations | 68 (34.34) | 112 (47.06) | 0.59 | 0.40–0.87 | 80 (40.82) | 100 (41.67) | 0.97 | 0.66–1.42 |
Congenital malformations of the circulatory system | 43 (21.72) | 42 (17.65) | 1.30 | 0.81–2.08 | 35 (17.86) | 50 (20.83) | 0.83 | 0.51–1.34 |
Congenital malformations of the gastrointestinal system | 34 (17.17) | 26 (10.92) | 1.70 | 0.98–2.93 | 29 (14.80) | 31 (12.92) | 1.17 | 0.68–2.02 |
Respiratory disorders originating in the perinatal period | 21 (10.61) | 20 (8.40) | 1.29 | 0.68–2.46 | 18 (9.18) | 23 (9.58) | 0.95 | 0.50–1.82 |
Congenital malformations of the nervous system | 12 (6.06) | 6 (2.52) | 2.50 | 0.92–6.77 | 8 (4.08) | 10 (4.17) | 0.98 | 0.38–2.53 |
Congenital malformations affecting multiple systems | 4 (2.02) | 11 (4.62) | 0.43 | 0.13–1.36 | 7 (3.57) | 8 (4.17) | 1.07 | 0.38–3.02 |
Other diagnoses | 16 (8.08) | 21 (8.82) | 0.91 | 0.46–1.79 | 19 (9.69) | 18 (7.50) | 1.32 | 0.67–2.60 |
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Rzońca, E.; Świeżewski, S.P.; Gałązkowski, R.; Bień, A.; Kosowski, A.; Leszczyński, P.; Rzońca, P. Neonatal Transport in the Practice of the Crews of the Polish Medical Air Rescue: A Retrospective Analysis. Int. J. Environ. Res. Public Health 2020, 17, 705. https://doi.org/10.3390/ijerph17030705
Rzońca E, Świeżewski SP, Gałązkowski R, Bień A, Kosowski A, Leszczyński P, Rzońca P. Neonatal Transport in the Practice of the Crews of the Polish Medical Air Rescue: A Retrospective Analysis. International Journal of Environmental Research and Public Health. 2020; 17(3):705. https://doi.org/10.3390/ijerph17030705
Chicago/Turabian StyleRzońca, Ewa, Stanisław Paweł Świeżewski, Robert Gałązkowski, Agnieszka Bień, Arkadiusz Kosowski, Piotr Leszczyński, and Patryk Rzońca. 2020. "Neonatal Transport in the Practice of the Crews of the Polish Medical Air Rescue: A Retrospective Analysis" International Journal of Environmental Research and Public Health 17, no. 3: 705. https://doi.org/10.3390/ijerph17030705