O2110: Intra-transport Medication Use by a Regional Neonatal Transport Service

Background: Each year in the U.S., an estimated 68,000 infants require transport between facilities by specialized neonatal transport teams. Many transports cover large distances and require long intra-transport times. It is critical for patient safety that the transport team provide all the necessary fluids and medications during the transport process.

Methods: We performed a retrospective analysis of neonates transported by the Seattle Children’s Hospital (SCH) Neonatal Transport Team. The SCH transport service includes a critical care transport nurse, a respiratory therapist, and an emergency medical technician. All patients transported to the neonatal intensive care unit (NICU) or cardiac intensive care unit (CICU) between January 2019 and April 2021 were included. Information on demographics, enteral and parenteral fluids, infusions, and medications used during the transport were categorized by type and frequency. Descriptive data analysis was performed.

Results: Data on 628 patient transports were included with 257 (41%) preterm infants. Three hundred and eight (49%) infants received at least one medication or fluid during transport. Dextrose 10% for nutrition and prevention of hypoglycemia was the most common fluid infusion received by 44% of transported infants, followed by hydration fluids: 0.9% NaCl (7%) and 0.45% NaCl (4%). Antibiotics (ampicillin, gentamicin), cardiac medications (prostaglandin), and opiates (morphine sulfate, fentanyl) were the most commonly administered medications (Tables 1 and 2). Term infants received a greater number of fluids and medications than preterm infants (196, 53% vs 110, 43%, respectively).

Conclusion: Many neonatal transports require the provision of fluids and medications, with hydration and nutritional fluids, antibiotics, prostaglandin, and pain medications being the most common. Transport teams need to be equipped and trained to provide a wide variety of medications and fluids.