Transportation to another hospital or special care unit

The best means of transportation for the premature child is "in utero", i.e. directing and transporting the pregnant woman to a specialized neonatal delivery department. Unfortunately, this it is not always possible. Transportation of a newborn premature baby is a very responsible activity.

Who organizes and carries out the transport of the premature child?

The neonatologist / pediatrician, who was present during birth, takes the first care and resuscitation of premature child.  They assess the need for transporting the child, based on the regulations in accordance with the requirements for transferring preterm infants (according to the Medical standard of Neonatology). Depending on the condition of the infant, this can happen in emergency or to be planned for an appropriate time. The doctor organizes the transportation of the baby, contacts the respective hospital and hospital ward, presents the case and agrees approximate time of arrival of the child. During transportation, which is accomplished with fully equipped ambulance, care and monitoring of the baby is a responsibility of a doctor. When necessary, e.g. twins, a nurse / midwife can be added as a second member of the team.

Why should my child be transported?

Neonatal wards in our country are organized into three levels of competence according to number of births, medical equipment availability, personnel, and the history of already performed medical activities. Transportation of the premature baby is necessary when it needs a higher level of neonatal care - assisted ventilation, surfactant treatment, prolonged intensive care, tests, monitoring and others. Your healthcare professional will explain what requires the transfer of your baby.

Why is it so important when and how it will be transported?

Depending on the condition of the baby, in some cases, the transfer must be done as quickly as possible. This is vital when the baby has hindered vital functions or deterioration of the condition. The doctor provides optimal preparation for transport –assisted ventilation and / or oxygen if necessary, optimum body temperature, venous access, stable cardiac activity and others. Timely, and in a stabilized condition, transfer of the baby is important for the favourable influence on its condition and for the prevention of possible later negative consequences.

Can I see my child before transportation?

Yes, depending on the condition of the mother after birth. When she is incapable of seeing it, the father and / or close relatives have the right to see the child. After receiving information about the baby, the reasons necessitating transfer, and get awareness of the risks of transport, parents / guardians sign an informed consent form for the transport.

Who will take care of the baby during transport?

Transport and monitoring of the newborn is always carried out by qualified personnel –a doctor with or without a nurse. Skin colour, breathing, cardiac activity and other indicators are monitored during transportation. The required equipment set that is specifically designed for the transport of newborns is available for this purpose.

Who and where will admit the baby?

Parents are carefully and fully informed about the hospital, the department, and the clinic where the baby will be transported. They are also informed about the name of the doctor who is familiar with and prepared to meet their baby. It is helpful if this information is given in a written form–an address, a ward, a doctor, a telephone contact number and time in which they can receive information about their child. The doctor who has transported the baby gives feedback to the parents about how the child has tolerated transportation and where it has been admitted.

Who will inform me and will I be able to see my child after my discharge?

In line with the established internal regulation of the respective department, the parents receive daily details of the child. After the mother has been discharged from the maternity ward, she could see her child during visit times. In emergency admittance from another hospital, regardless of the time during the day, the parents (usually the father) are given information by the doctor who has admitted the baby. It is necessary that you show understanding and patience for some time, which is required of the medical team to admit and take care of your baby. Sometimes, it is necessary to carry out urgent tests, procedures and activities in connection with the life and health of your baby. Once the doctor has taken the necessary urgent measures, he will inform you about the child's condition. The practice in most departments is allowing the father to see the baby. That is how he will get an idea where it is placed, how it looks, etc.

Is there any danger to the health and life of the baby during transportation?

Depending on the child's condition and the degree of immaturity (birth weight, gestation weeks, etc.),there is danger to the life and health of the child. Other important factors are: the remoteness of the hospital in which the baby will be transferred, degree of the child's condition stability (basic life functions - breathing, heart rate, body temperature, etc.), available and working equipment for the transport of newborns, delays in transportation due to objective circumstances and so on. That is why, transporting the baby is done only if absolutely necessary and following the assessment of the treating physician.

When to transfer a child in the special care unit?

A „special care structure „is a separate unit in neonatology. It treates premature infants who have received intensive care, preterms who require an extended period of special care, and who are without pathological conditions until reaching discharge weight. It may be within the NICU. In these cases, when your baby is ready to be taken care for at home, it will be discharged by the NICU. In some cities of the country, there are separate special care units or medico-social care homes for children.
After stabilizing the child's condition and the absence of a direct threat to the life of your baby, it can be transferred in such a unit. Care, treatment, nutrition, tests, monitoring and others are continued there. A qualified medical staff of doctors and nurses / midwives is taking care for the child. Information, visits and parent education are being carried out according to the established internal regulations of the unit / home.

Decision making, organization, implementation and quality of neonatal transportation are essential to protect the lives and health of premature babies, as well as to minimize the possible late consequences for the child. It is carried out by qualified medical personnel, according to the standard for neonatology in our country. This document regulates exactly: the basic requirements for the implementation of intra-hospital and inter-hospital neonatal transport, the indications for transfer, the organization and the equipment.

Welcome to  "All About Premature Babies" website.
This is a project of "Our premature babies" Foundation based in Bulgaria. The book is a result of a team’s hardwork that includes doctors, psychologists, breastfeeding consultants and premature babies parents. The common information about premature babies which you can find here will help you understand better the situation you've been facing.
Please keep in mind that some of the information related to the neonatal intensive care units is prevalent only in Bulgaria.

We hope that this website and the book are going to help you to be more informed, calm and confident. We wish you and your baby best of luck and health.

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