Transport Team member describes his work.

During this week, from May 11 - 17,  National Nursing Week in Canada, we celebrate and are thankful for dedicated men and women who have chosen nursing as a profession. The World Health Organization (WHO) has designated 2020 as the Year of the Nurse and Midwife in honour of the 200th anniversary of Florence Nightingale's birth. 

A few days ago, two health workers allowed me to sketch them in PPE.  Working in tight spaces, the nurse in the header image, provides medical attention to critically ill newborn babies.

The second health worker, an RT (Respiratory Therapist), describes the essential service the team provides in Ontario.

Thank you to all health care workers for your dedication and commitment in caring for sick, vulnerable, and frightened patients, big and small.

 

Transport Team is a mobile ICU for babies and infants

Our team is dedicated to transporting neonates and infants of less than 6 kg from referral hospitals in Ontario. We can be asked to transport patients from anywhere in Ontario, to Ottawa, Canada. Generally, though, we service our own dedicated LHINs (Local Health Integration Network).

In fact, our total coverage is approx. 440 000km2, which is larger than countries like Sweden, Germany and Japan. In addition, we cover western Quebec.

It’s projected that our team will also service pediatric cases of less than 2 years old within the next year. This presents some challenges for our team in terms of equipment, personnel, and training.

We often transport the most critical and unstable small patients. Referral hospitals, especially the more remote hospitals, are likely under equipped, under staffed, and not generally trained for sick infants.

In short, we are a mobile ICU with all the necessary equipment and training for all difficult cases.

COVID pandemic adds more prep time to patient care

Our work has changed since this pandemic began.

Because we are a small team, if one person is infected, most likely two or more of our team will also become infected.

So when a call comes in, and we must leave the hospital to go stabilize and transport a patient, we conduct a first screening for COVID. If it is suspected or confirmed, we ensure to bring all PPE needed for the call.

On a regular call, we would wear gloves, mask, and uniform.  However, for a COVID call, we add N95 mask, face shield or goggles, disposable gown, and two pairs of extra long gloves.

Nurse in full PPE - challenges of PPE - rain out inside of visor and fogging of glasses.

Safety protocols for Transport Team during COVID pandemic

We wear the PPE going into the patient’s hospital and bring only the strict necessities when we enter the patient’s room. A referral nurse remains outside the room to hand us whatever else we might need from our equipment bags.

Once we have stabilized the patient, we pack the baby on our stretcher. Before leaving the room, we disinfect our stretcher and all our used equipment twice.

After we leave the room, we remove our PPE, we wash our hands thoroughly, put on a clean PPE for the ride back to the admitting hospital.

As we arrive, we talk to a screener who calls an escort for us so we don’t touch anything in the hospital. For example, we don’t touch door handles, elevator buttons…

Once we have released the patient to the neonatal team within the hospital, we disinfect all our equipment twice and wash our hands after removing all PPE. Then, we restock our equipment, and prepare for our next case.

Cleaning our equipment is a lengthy process as we have lots of little nooks and difficult to reach parts. This adds a layer of difficulty to our job.

Our specialized tasks on this very particular patient population require a different approach than the techniques used for the adult population.

A peer group and medical director review all our cases.

Respiratory Therapist in PPE on recent transport call.

Special challenges with PPE

With COVID, we are still learning about our PPE.

For instance, we are tested for other N95 masks in case of a shortage of our individual fit tested masks.

Our hospital is also researching ways masks can be reused, again in case of shortage.

We are experiencing a lot of condensation on our visors or ocular glasses so it can be very challenging to work through all the “rain out” or droplets that accumulate in the visor or glasses.

In preparation for this pandemic, we have had many different simulations. For example, we even practice how we enter the hospital with our escorts.

We always depend on each other within the team for moral support, but especially so during these stressful situations.

 

2 Responses

  • Wow, who knew about these specialists and thankful for how many lives they save. They truly are unsung hero’s. Gives me tears.

    • Thanks Nelvia for leaving a comment. 😘The Respiratory Therapist in the article is a clinician therapist. He had to pass a series of tests to enter and to exit the program as well as perform difficult case simulations in front of a panel of physicians. Then he had to get cleared to perform the procedures independently. Clinician therapists are like pediatric residents although they are not paid the salary a pediatric resident would receive. This person also teaches other student respiratory therapists.

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