Since transporting the first tiny patient in 1971, Children’s Mercy’s Critical Care Transport program has grown to one of the busiest in the country. In 2010, the transport team performed nearly 5,000 pediatric transports, about a quarter of them neonates.
“We handle everything from extreme prematurity, to birth defects, to other congenital anomalies, to heart defects,” says Emily McNellis, MD, Director of Transport for Children’s Mercy. “We also transport patients from other level III NICUs for specialty services that they can’t get at their referral hospital.”
As the only level IV NICU within a 250-mile radius catchment area, Children’s Mercy transports patients mostly from Kansas and Missouri. However, the team also transports patients from across the nation and internationally. The Critical Care Transport team is made up of more than 70 dedicated staff members and experiences little turnover in personnel.
“A few of our staff members have been there for close to 20 years and love their jobs,” says Dr. McNellis. “The experience that they all have contributes to how well our transport team does clinically. What sets us apart are the clinical outcomes of our kids. Neonates come in warm and adequately ventilated and adequately cared for.”
The transport team’s goal is to bring Children’s Mercy’s NICU to the patient, stabilizing the patient at the referral hospital rather than rushing to transport with the goal of stabilizing after arrival. Bringing a more stabilized pediatric patient back to Children’s Mercy reduces mortality and morbidity in the long run.
“By bringing the intensive care unit to the infant, all the technical innovations that you have at your fingertips in the NICU you’ll now have on wheels or in a rotor wing or in a fixed wing,” Dr. McNellis says. “And the level of care is going to be just the same as what you’re going to get in the NICU.”
The self-funded program handles an average of 15 to 17 calls each day, with five teams on duty during peak times. Each team includes a registered nurse, a registered respiratory therapist and an EMT. Their fleet includes nine ground ambulances, a helicopter and a fixed-wing plane, all loaded with the specialized equipment and supplies needed to treat seriously ill neonates.
“These babies require very specialized care,” says Dr. McNellis. “We transport them in incubators, we’re capable of doing high-frequency ventilation, and we carry oxygen, air, nitric oxide and heliox. Our teams have the training to perform high-level skills like oral intubation, inserting invasive lines and interosseous lines, inserting chest tubes to resolve pneumothorax -- things a typical ambulance can’t provide. We bring a lot of experience and skill to the patient’s bedside.”
And safety is a priority; even infants small enough to fit in the palm of an adult’s hand are appropriately restrained at all times.
“We are a dedicated transport program,” Dr. McNellis says. “All we do is transport, so we know it well.”