Improving inter-hospital transport for sick newborn infants
Each year on average there are 16,000 newborn transfer journeys. For the majority of these babies this is a safe clinical pathway and allows them to access the care they require. However, for a small number of high risk infants it is also necessary but could expose them to additional risks from noise, vibration, discomfort and, rarely, potential accidents involving the ambulance.
Our teams have been studying this for many years and have presented some of the most detailed studies ever done in this field. Thanks to funding from Nottingham Hospitals Charity and the Medical Research Council we have been able to grow our research to become one of the international leaders in this field (you can see our latest paper here).
What can be done to improve neonatal transport?
We believe we can make huge improvements in neonatal transport to improve the outcomes for these babies. Currently we are undertaking a complete redesign of the neonatal transport system to address many of the weaknesses of the present technologies.This work will reduce vibration, reduce noise exposure, improve comfort, reduce the risk of injury if involved in an accident and equip the transport team with new devices to monitor and measure all of these. This work is being support by over £1M of funding from NIHR and Research Councils to develop the next generation neonatal transport system. We are also working closely with industrial partners, ParAid Medical and Jaguar Land Rover, to make sure this system is world leading.
Our Team
This collaborative research is only possible thanks to our academic, clinical and industrial partnerships. The Nottingham Neonatal Transport Research Collaborative (N-NTRC) comprises The University of Nottingham, CenTre Neonatal Transport Service, Nottingham University Hospitals NHS Trust (NUH), ParAid Medical and Jaguar Land Rover.The research team can be contacted via CenTre or contact the academic lead Don Sharkey directly.
Research
Our strength lies in the ability to undertake laboratory based research and quickly translate this into the clinical domain with responsive clinical trials recruiting real neonatal patients transferred between centres. We utilise a number of cutting edge techniques to accelerate our research:
- Using advanced computer simulation models to redesign neonatal transport systems and ‘crash test’ them in the virtual world based on actual laboratory data.
- Our engineering facility at the University of Nottingham houses a crash sled track to allow restraint systems to be developed and tested against a variety of standards or beyond if required.
- We have state of the art physiological and environmental monitoring systems designed or purchased for clinical studies in real ambulances. These include all vital sign monitoring and recording, video analysis including ultra-slow motion, near-infrared spectroscopy (NIRS), noise monitoring and vibration analysis to industry standard.
- We will have a purpose designed and built research transport incubator system to study modifications in more detail.
- In 2017 we purchased our own research ambulance to allow on-the-road studies to be conducted with new developments based on our research.
- We are developing alternative models of transport stress to explore potential interventions to improve the outcomes of babies
- Our work with Jaguar Land Rover will explore cross pollination of ideas between the automotive industry and neonatal transport.
- We are analysing large datasets to understand the outcomes of babies transported between centres with the aim of identifying vulnerable groups and interventions to improve their outcomes.
We welcome any interest in our work and collaborative opportunities as we believe there are more opportunities to improve neonatal transport by working together. We already work with the Embrace Transport Team collaborating with them to aid the establishment of clinical trials. We are also working with the UK Neonatal Transport Group and hope to identify shared research ideas we can develop into clinical studies.