Keeping Babies Breathing

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Helicopters, planes and ambulances -transporting babies in need of critical care has a real life urgency that can’t be captured in any action movie.

Imagine a miniature ICU in a helicopter where a registered respiratory therapist and a registered nurse are working to stabilize an infant. This infant has been born in a community center with unexpected complications ranging from premature birth to congenital anomalies requiring surgical intervention. The registered respiratory therapist and the registered nurse have advanced training in caring for and transporting these babies. This is a specialized team that works in the field with support and guidance from a physician through telephone contact back at the hospital.

Melissa McLean is one of these specially trained respiratory therapists and part of the Neonatal Transport Team at the Children’s Hospital of Eastern Ontario (CHEO). Located in Ottawa, CHEO is dedicated to delivering specialized neonatal and pediatric health services. There are 30 respiratory therapists at CHEO working round-the-clock rotations as members of interdisciplinary teams caring for children with cardio-respiratory illnesses.

The neonatal transport team is one of these teams. Transports may take the team as close as next door or as far away as Nunavut. These transports may take two to 15 hours depending on the severity of the infants’ condition and the location. Challenges range from coping with extreme weather conditions and the availability of reliable transport to dealing with various types and severity of medical emergencies.

While dealing with these challenges, the neonatal transport team is communicating with the family and the staff at the referring hospital, providing essential care to the infant and relaying necessary information back to the health-care team at CHEO.

One of the most difficult things about transporting newborn babies is taking them away from their parents. Imagine that you have just delivered your much anticipated and loved newborn baby and finding out that everything is not okay. “The moment when you walk away with their little baby bundled in an incubator attached to beeping monitors is incredibly hard,” said respiratory therapist, Melissa McLean.

To ease the pain of separation from their babies, the neonatal transport team attempts to reassure the parents and provide them with photos of their baby along with an information package from CHEO about what they can expect.

Despite the vulnerability of babies and children, Judy MacGregor, Respiratory Therapist and Professional Practice Leader at CHEO, loves working with this patient population because of the hopeful atmosphere. “Miraculous recoveries just seem to happen more often in the young” said MacGregor.

Recent trends in neonates and pediatrics that are keeping respiratory therapists and other health-care providers in critical care occupied include: premature and multiple births with their unique complications, asthma, bronchiolitis, and many chronic diseases like muscular dystrophy which often lead to respiratory compromise.

“Respiratory Therapists also provide valuable airway management skills throughout the hospital. This role extends from the emergency department to the intensive care unit and into the operating room,” said MacGregor.

There is a significant increase in the number of children suffering from asthma. Fortunately, asthma can be successfully managed with effective education and proper medication. Children with asthma may be seen as outpatients at the CHEO Asthma Centre where respiratory therapists specialized in asthma education teach parents and children how to manage the disease.