The role of the Carilion Clinic Neonatal Pediatric Transport Team
On any given day, hundreds of people help make a hospital run, from physicians and nurses to guest services and maintenance. One part of this large group of healthcare professionals is a small team with a big job—caring for the smallest and most fragile of patients. Carilion Clinic’s Neonatal Pediatric Transport Team is the only team of its kind in southwest Virginia. Answering approximately 600 calls a year, and covering 13,000 square miles in Virginia and neighboring states, to treat and transport intensive care infants, children, and adolescents.
“We are a specialty pediatric care team, which means the children we care for require specialized and high-quality treatment from the second we arrive,” said Alex Brendel, a Carilion Clinic registered respiratory therapist.
The hospital-trained team spends 50 percent of its time responding to intensive care calls. On each shift the team consists of three members, a registered respiratory therapist (R.R.T.), a registered nurse (R.N.), and an emergency medical technician (E.M.T.). The other 50 percent of the team’s time is spent at the Carilion Clinic Children’s Hospital (CCCH) – a “hospital within a hospital” inside Carilion Roanoke Memorial Hospital (CRMH).
“When we aren’t out on a call, we’re not just waiting for one to come in,” Brendel said. “We’re at the children’s hospital working with the staff to help care for patients. This helps us keep our skills up and we can be another resource to the hospital staff, especially during emergencies.”
The team cares for children up to age 18. Most are critically ill and need specialty care they cannot receive from other medical facilities.
To better understand the role this team plays, here’s an inside look at one of its days.
8 a.m.: The team meets inside its office on the CCCH floor at CRMH. On this day the team consists of Brendel, R.R.T., and clinical team leader, Ghislaine Cady, R.N., Jesse Saunders, E.M.T.-B., and Cindy Johnson, R.N., a longtime nurse who is now training with the team.
9:15 a.m.: A call comes in. Brendel answers the phone and immediately begins taking notes. On the call with Brendel are the sending physician from the other medical facility, the receiving physician from CCCH, and the Carilion Clinic Transport Center, which coordinates the transport of the patient. This is an opportunity for everyone to get on the same page when it comes to understanding the patient’s needs and making sure the best course of treatment is provided.
Once off the phone, Brendel updates the team. The patient is a baby girl, whose mother was addicted to drugs, and prescribed methadone in order to stop using. Unfortunately, the baby was born addicted to methadone. The originating hospital has been trying to wean the baby off of methadone, but hasn’t been successful and is now asking CCCH to help with more advanced treatment. The Neonatal Pediatric Transport Team has been called upon to pick up the baby and bring her to the Neonatal Intensive Care Unit (NICU) at CCCH.
10 a.m.: The team hits the road to a hospital in West Virginia—about a two-hour drive from Roanoke.
Noon: The team arrives at the hospital and heads to the pediatric unit. Cady and Brendel immediately start checking the baby’s heart rate, blood pressure, and listen to her lungs. At the same time, the staff is updating the team on the baby’s overall condition.
12:20 p.m.: The team is ready to transport the patient. The baby is placed securely inside an incubator on a stretcher.
12:25 p.m.: The team leaves the hospital with the patient. Cady calls the receiving physician at CCCH, to update the baby’s condition and take information on any care that may need to be administered while on the road.
2:30 p.m.: The team arrives at the NICU at CCCH and updates the nurses and neonatologists on the situation. It’s now time to sign the patient over to the care of the NICU staff. While the paperwork is being completed, Saunders cleans and sterilizes the incubator and stretcher. This way it’ll be ready for the next call.
It’s hard to encompass all of what this team does from one day to the next, because everyday is different. The needs of each patient are different, the locations the team travels to are different, and the scope of care the team provides is extensive. To help the team provide the best care available, it now utilizes a specialized pediatric mobile ICU.
Made possible by donations from the community through Children’s Miracle Network Hospitals, the vehicle is significantly larger than the average ambulance and a kid-friendly illustration is on the outside of the vehicle. Those are only two things that make this “ICU on wheels” stand out.
“There are a lot of amenities inside the unit,” Saunders said. “Some aren’t necessary for direct medical care, like a DVD player above the stretcher area, but they do benefit the patient, especially during situations that may be scary for a child.”
But it’s not the extras in the vehicle that are most important for young patients – it’s the safety features. The team says safety, for patients and the team, was the top priority when designing the vehicle. For instance, in the front of the truck the entire team can sit, all facing forward. This not only improves safety, but helps with communication while on the way to a call.
In the patient area of the unit, space is much larger than that of a typical ambulance. The vehicle has room for two pediatric stretchers and four crew members. The R.R.T. and R.N. can sit at the head and side of a patient respectively, which enables them to care for the patient while remaining seated at all times. This can benefit the patient’s safety and care, along with the team member’s safety.
The vehicle also has lifts on the chairs and more insulation, which helps lessen vibrations and bumps while traveling. This feature especially helps neonates, the most delicate of newborns, who can suffer greatly from unexpected movements.
“Being on this team can be emotional,” Saunders said. “We treat very sick children everyday. But everyone on our team cares so much about children, we’ll go wherever we need to go and do whatever we can to help our patients.”
For more information on the Neonatal Pediatric Transport Team or how to support the team through Children’s Miracle Network Hospitals, visit CarilionClinic.org/kids.
Laura Markowski is a writer for Carilion Clinic’s marketing communications department.