Summary: Located on the northernmost coastline of Australia, Royal Darwin Hospital (RDH) is the first point of referral for more than 60 remote communities, servicing an area > 650 000 2 km². Aeromedical transfer of infants for sub-specialist review or an escalation in medical care to quaternary services requires a minimum of four hours of flight time. Since commencing in April 2018, the Northern Territory Neonatal Emergency Transport Service (NETS NT) has transferred more than 30 infants to interstate hospitals. This case series reviews the transport of four critically unwell infants from RDH to two quaternary hospitals, each more than 3400km from Darwin. All babies were transferred in the setting of respiratory failure requiring High Frequency Oscillatory Ventilation (HFOV) to access locally unavailable therapies, both surgical and medical. Three of the four infants were born very prematurely, 2500km transfer of 4 critically unwell infants receiving HFOV is unique, with lessons learned in this highly specialized environment. This case series will discuss the specific preparations required, including pre-departure stabilization, preparation for and management of in-flight deteriorations, and consideration of specialized equipment given the long flight time on HFOV.
Cooney et al. (Sun,) studied this question.