Regionalized neonatal emergency transport.

This article reviews the components that facilitate an effective neonatal emergency transport network, and discusses the human resources required for safe transport, including a section focused on the option of an expanded role for the paramedic. In addition, the topics of transport equipment, communications, quality assurance, data management, family support and education are addressed in the context of a neonatal transport programme. Finally, elements involved in the organization of neonatal transport and transport issues pertaining to networking of neonatal medical care are highlighted and illustrated with reference to local experience in British Columbia.

Variations in rates of nosocomial infection among Canadian neonatal intensive care units may be practice-related.

Background: Nosocomial infection (NI), particularly with positive blood or cerebrospinal fluid bacterial cultures, is a major cause of morbidity in neonatal intensive care units (NICUs). Rates of NI appear to vary substantially between NICUs. The aim of this study was to determine risk factors for NI, as well as the risk-adjusted variations in NI rates among Canadian NICUs.

Infants with congenital anomalies admitted to neonatal intensive care units.

The objective of this study was to describe the congenital anomalies in 17 Canadian neonatal intensive care units (NICUs) and their impact on mortality, morbidity, and resource utilization. This study was performed using a database analysis of 19,507 consecutive admissions. Results show that 13.

Higher mortality rates among inborn infants admitted to neonatal intensive care units at night.

Objective: To examine circadian variation in deaths among infants < or =32 weeks' gestation admitted to Canadian neonatal intensive care units (NICU).

Study Design: We examined all infants (n=5192) between 24 and 32 weeks' gestation with complete data, who were admitted to 17 tertiary Canadian Neonatal Network NICUs from January 1996 to October 1997. Multivariable logistic regression was used to compare risk-adjusted early neonatal mortality rates (death within 7 days of NICU admission) of infants admitted during daytime (8 am to 5 pm) with infants admitted at night.

Cost-effectiveness and choice of infant transport systems.

Objective: To compare cost-effectiveness of three types of infant transport models (Emergency Medical Technicians [EMT], Registered Nurses [RN], or Combined Teams [CT] of RNs and Respiratory Therapists) and to derive a decision model to guide choice of a transport system.

Research Design: A prospective, multicenter, observational study was conducted to compare infant physiologic status before and after transport. Cost-effectiveness analysis from the perspective of the third-party payer, sensitivity analysis and threshold analysis were performed.