west midlands neonatal transfer service cooling activity april 2012 ~ march 2013

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West Midlands Neonatal Transfer Service Cooling Activity April 2012 ~ March 2013 April May June July Aug Sept Oct Nov Dec Jan Feb Mar 0 1 2 3 4 5 6 7 Requests Transfers Refusal/Cancellation

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Page 1: West Midlands Neonatal Transfer Service Cooling Activity April 2012 ~ March 2013

West Midlands Neonatal Transfer Service

Cooling ActivityApril 2012 ~ March 2013

April May June July Aug Sept Oct Nov Dec Jan Feb Mar0

1

2

3

4

5

6

7

RequestsTransfersRefusal/Cancellation

Page 2: West Midlands Neonatal Transfer Service Cooling Activity April 2012 ~ March 2013

West Midlands Neonatal Transfer Service

Requests from

BWH

City

Good Hope

Linco

ln

New X

Redditc

h

Russells

Hall

Stafford

Wals

all

Warw

ick

Worce

ster

Hereford

0

2

4

6

8

10

12

Page 3: West Midlands Neonatal Transfer Service Cooling Activity April 2012 ~ March 2013

West Midlands Neonatal Transfer Service

Transfers requests Per network

CNN

SSBCNN

SMWNN

17

32

2

Page 4: West Midlands Neonatal Transfer Service Cooling Activity April 2012 ~ March 2013

West Midlands Neonatal Transfer Service

Transfer To

New Cross Heartlands UHNS BWH0

5

10

15

20

25

Page 5: West Midlands Neonatal Transfer Service Cooling Activity April 2012 ~ March 2013

West Midlands Neonatal Transfer Service

17

• 14

Transfers performed To each network

• 50% of babies were admitted to SSBCNN for therapeutic hypothermia

• 50% of babies were admitted to SWMNN for therapeutic hypothermia

Page 6: West Midlands Neonatal Transfer Service Cooling Activity April 2012 ~ March 2013

West Midlands Neonatal Transfer Service

Transfers performedReferral age

Within 1 hour

Within 2 hours

Within 3 hours

Within 4 hours

Within 5 hours

Within 6 hours

Greater than 6 hours

0

2

4

6

8

10

12

14

16

18

20

Number of babies

Page 7: West Midlands Neonatal Transfer Service Cooling Activity April 2012 ~ March 2013

West Midlands Neonatal Transfer Service

Transfers performedResponse time (Call → Arrival on Ref. NNU)

Within 1 hour

Within 2 hours

Within 3 hours

Within 4 hours

Within 5 hours

Within 6 hours

Greater than 6 hours

0

5

10

15

20

25

30

Number of transfers

Page 8: West Midlands Neonatal Transfer Service Cooling Activity April 2012 ~ March 2013

West Midlands Neonatal Transfer Service

Transfers performedAge at Cooling centre

Within 5 hours

Within 6 hours

Within 7 hours

Within 8 hours

Within 9 hours

Within 10 hours

Within 11 hours

Within 12 hours

Greater than 12 hours

0

2

4

6

8

10

12

14

Number of babies

Page 9: West Midlands Neonatal Transfer Service Cooling Activity April 2012 ~ March 2013

West Midlands Neonatal Transfer Service

Transfers performedAge 33-34°C Achieved

Within 1 hour

Within 2 hours

Within 3 hours

Within 4 hours

Within 5 hours

Within 6 hours

Greater than 6 hours

0

2

4

6

8

10

12

14

16

Number of babies

Page 10: West Midlands Neonatal Transfer Service Cooling Activity April 2012 ~ March 2013

West Midlands Neonatal Transfer Service

Transfers performedMethods of cooling

Active – inactivated transwarmer

Active – cool water gloves

Passive

0 5 10 15 20 25 30 35

Page 11: West Midlands Neonatal Transfer Service Cooling Activity April 2012 ~ March 2013

West Midlands Neonatal Transfer Service

Transfers performedBabies not cooled

< 33°C

> 34°C

0 1 2 3 4 5 6 7 8 9

Number of babies

Page 12: West Midlands Neonatal Transfer Service Cooling Activity April 2012 ~ March 2013

West Midlands Neonatal Transfer Service

Transfers performedVentilatory support

Ventilated Ventilated + Nitric Oxide CPAP SVIA0

5

10

15

20

25

30

35

40

45

50

Page 13: West Midlands Neonatal Transfer Service Cooling Activity April 2012 ~ March 2013

West Midlands Neonatal Transfer Service

Transfers performedParalysis & sedation

Morphine Morphine + Paralysis Nil0

5

10

15

20

25

30

35

40

Page 14: West Midlands Neonatal Transfer Service Cooling Activity April 2012 ~ March 2013

West Midlands Neonatal Transfer Service

Transfers performedPhenobarbitone use

Phenobarb Loading Dose Phenobarb Loading + Maintenance Nil0

5

10

15

20

25

30

Page 15: West Midlands Neonatal Transfer Service Cooling Activity April 2012 ~ March 2013

West Midlands Neonatal Transfer Service

Transfers performedInotropic support

Dopamine

Dobutamine

Dopamine + Dobutamine

Nil

0 5 10 15 20 25 30 35 40