IFT p/u flight crew

[rhan101277]

This was my second one of these. They don't happen often but this one was tough on me. We went to pick up a flight team. They were going to the NICU. We get there load up the encubator and head on. We get to the NICU and find a 8 day old baby. She is tachypneac (80 bpm) and tachycardiac (160 bpm), i thought this was on the high end of the range for neonatals, we were curious about what was going on. She had left ventricular hypertrophy along with holes in her septum, which was actually keeping the baby alive. Without those holes there wouldn't have been enough perfusion to sustain life. Hearing the little baby let out a little cry every now and then was touching. They put her in the incubator and get her all hooked up and we head out.

There was a nurse practitioner and RRT on board. I think she was going to have some surgery and was expected to live a normal life, but will always have to see a cardiologist. It just made me feel alot better about doing my job. I noticed one of the EKG leads was tightly pulled across towards her right shoulder causing the skin to fold over it, I pointed this out and I felt like I made a difference somehow. They re-arranged it.

Anyhow just thought I would mention this call, first baby call for me. Even though the baby wasn't under our care.

 

[VentMedic]

Here is a website for some CHDs.

http://www.thic.com/hyporight.htm

Since there was LV hypertrophy, the right venticle might have been hypoplastic.

Did you notice what FiO2 of oxygen was being given? How was the SpO2? Did you notice the location of the SpO2 probe?

 

[lightsandsirens5]

A friend of mine went to pick up a flight crew at the hospital once to transport them to a rural clinic to pick up a pt. Then they were supposed to take them and the pt back to the hospital LZ so they could load the guy and fly him to a bigger hospital. Well, en-route back to the hospital, the flight crew remembered they had left their flight notebook at the clinic, so our crew had to turn aroud and go get it. Once they started back to the hospital again, the pilot on the ground, an hour and a half drive away called and said he was leaving because the weather was closing in and he wouldn't be able to get off the ground in a few minutes. So he left and our crew had to transport the pt and flight crew to the hospital they were supposed to fly to. It ended up being like a 9 hour run.

I'm just glad I wasn't on it!

 

[marineman]

We do that fairly often by design. If we have a patient that would normally be flown out and the weather is too bad to fly we will transport by ground with the flight team in the back of the rig. I quite enjoy those calls since I don't have to do anything, my report takes 30 seconds (flight team handled all patient care is the entirety of the narrative) and you can learn so much just by sitting back with nothing to do but watch.

 

[medicdan]

I've done many of these CCT Neonatal ground transfers.

Boston's Childrens Hospital is well known (alongside CHOP, etc.), and has physicians on faculty that specialize in many rare condtions, making it a magnet for high-risk patients.
My private company has a contact for many, if not all of these ground tranfers from the airpot. Inevitibly, we end up caught in airport security and politics relating to being able to drive out on to the tarmac. We end up loading a 400+ lb isolette with O2 and medical air bottles, in addition to all the other assorted equipment and drips, only to hold a 1.5 lb neonate, if even that.

I have certainly been witness to come close calls re: O2 and medical air running out, and on the calls I have been on, we often end up with a delay that annoys the pilots, who often come close to their rest requirements.

Knock on wood, these neonatal patients have never coded in my truck, but I have enormous respect for the crews that take. With each of these transports, I try to learn something new from the crew, whether it be about the equipment, patient, condition, the hospital where they are based, etc.

 

[mycrofft]

We did those long ago in Omaha.

As private EMT-A's who mostly did transports, we would mostly try not to look goofy, give them a smooth ride and if air tranport was needed, get them there on time. In fact, the owner/boss used to take most of those. The team out of the then-independent Children's Hospital did everything clinical.
Someone left the notebook behind? Someone's going to be flying a little lighter after the :censored::censored:se chewing they must have gotten.

 

[rhan101277]

Here is a website for some CHDs.

http://www.thic.com/hyporight.htm

Since there was LV hypertrophy, the right venticle might have been hypoplastic.

Did you notice what FiO2 of oxygen was being given? How was the SpO2? Did you notice the location of the SpO2 probe?

I am not sure of the terminology she used now that I think about it. I was sure she said the left pumping chamber was smaller which would be hypotrophy, but I googled it and got nothing. She said they were going to basically switch up everything and make the right ventricle the new left and vice versa. The Sp02 was in the 90's, the Sp02 probe was on the babies feet. She was just a breathing, and going at it.

 

[VentMedic]

I am not sure of the terminology she used now that I think about it. I was sure she said the left pumping chamber was smaller which would be hypotrophy, but I googled it and got nothing. She said they were going to basically switch up everything and make the right ventricle the new left and vice versa. The Sp02 was in the 90's, the Sp02 probe was on the babies feet. She was just a breathing, and going at it.

That now sounds like Hypoplastic Left Heart Syndrome which is also on that website I linked to.

90s is a very high sat for a ductal dependent congenital heart disease. We are sometimes happy with 75 - 85% and will use only 16% Oxygen to accomplish this if needed. Of course if the baby was on room air and the meds to keep the ductus open, the baby was good to transport.