Using internal transport databases and UK Neonatal Transport Group data submissions, we tracked local and national rates of ventilation and normocapnia. We correlated this with internal changes in practice, including introduction of new equipment, staffing changes, educational interventions and quality improvement projects.
Data demonstrated improvement in normocapnia rates benchmarked against national figures, which was not explained by changes in ventilation methods or rates, or by changes in availability of post-transfer gases. Greatest improvement was identified following introduction of transcutaneous CO2 monitoring and ventilators enabling volume-guided ventilation strategies. Additionally, although less quantifiable, educational and quality improvement interventions, and case review mechanisms were felt to be influential.
Volume guided ventilation and transcutaneous CO2 monitoring have had a positive influence on the maintenance of normocapnia during transfer at Embrace Transport Service, although introduction of new equipment still presents challenges which must be overcome. Recognising the significant impact of these technologies allows for ongoing financial, time and educational investment to emphasise their importance and ensure appropriate awareness of limitations and troubleshooting options, maximising their positive impact.
方法:使用内部运输数据库和英国新生儿运输组数据提交,我们追踪了当地和全国的通气率和正常碳酸血症.我们将这与实践中的内部变化联系起来,包括引进新设备,人员配置变化,教育干预和质量改进项目。
结果:数据表明,以国家数据为基准的正常碳酸血症率有所改善,这不能用换气方法或换气率的变化来解释,或通过转移后气体的可用性的变化。在引入经皮CO2监测和呼吸机以实现体积引导通气策略后,发现了最大的改善。此外,虽然不太可量化,教育和质量改进干预措施,案件审查机制被认为是有影响力的。
结论:容量引导通气和经皮CO2监测对环抱运输服务转移期间正常碳酸血症的维持有积极影响,尽管引入新设备仍然存在必须克服的挑战。认识到这些技术的重大影响允许持续的财务,时间和教育投资,以强调其重要性,并确保适当的局限性和故障排除选项的认识,最大化他们的积极影响。