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West Midlands Neonatal Transfer Service
Cooling ActivityApril 2012 ~ March 2013
April May June July Aug Sept Oct Nov Dec Jan Feb Mar0
1
2
3
4
5
6
7
RequestsTransfersRefusal/Cancellation
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West Midlands Neonatal Transfer Service
Requests from
BWH
City
Good Hope
Linco
ln
New X
Redditc
h
Russells
Hall
Stafford
Wals
all
Warw
ick
Worce
ster
Hereford
0
2
4
6
8
10
12
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West Midlands Neonatal Transfer Service
Transfers requests Per network
CNN
SSBCNN
SMWNN
17
32
2
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West Midlands Neonatal Transfer Service
Transfer To
New Cross Heartlands UHNS BWH0
5
10
15
20
25
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West Midlands Neonatal Transfer Service
17
• 14
Transfers performed To each network
• 50% of babies were admitted to SSBCNN for therapeutic hypothermia
• 50% of babies were admitted to SWMNN for therapeutic hypothermia
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West Midlands Neonatal Transfer Service
Transfers performedReferral age
Within 1 hour
Within 2 hours
Within 3 hours
Within 4 hours
Within 5 hours
Within 6 hours
Greater than 6 hours
0
2
4
6
8
10
12
14
16
18
20
Number of babies
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West Midlands Neonatal Transfer Service
Transfers performedResponse time (Call → Arrival on Ref. NNU)
Within 1 hour
Within 2 hours
Within 3 hours
Within 4 hours
Within 5 hours
Within 6 hours
Greater than 6 hours
0
5
10
15
20
25
30
Number of transfers
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West Midlands Neonatal Transfer Service
Transfers performedAge at Cooling centre
Within 5 hours
Within 6 hours
Within 7 hours
Within 8 hours
Within 9 hours
Within 10 hours
Within 11 hours
Within 12 hours
Greater than 12 hours
0
2
4
6
8
10
12
14
Number of babies
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West Midlands Neonatal Transfer Service
Transfers performedAge 33-34°C Achieved
Within 1 hour
Within 2 hours
Within 3 hours
Within 4 hours
Within 5 hours
Within 6 hours
Greater than 6 hours
0
2
4
6
8
10
12
14
16
Number of babies
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West Midlands Neonatal Transfer Service
Transfers performedMethods of cooling
Active – inactivated transwarmer
Active – cool water gloves
Passive
0 5 10 15 20 25 30 35
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West Midlands Neonatal Transfer Service
Transfers performedBabies not cooled
< 33°C
> 34°C
0 1 2 3 4 5 6 7 8 9
Number of babies
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West Midlands Neonatal Transfer Service
Transfers performedVentilatory support
Ventilated Ventilated + Nitric Oxide CPAP SVIA0
5
10
15
20
25
30
35
40
45
50
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West Midlands Neonatal Transfer Service
Transfers performedParalysis & sedation
Morphine Morphine + Paralysis Nil0
5
10
15
20
25
30
35
40
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West Midlands Neonatal Transfer Service
Transfers performedPhenobarbitone use
Phenobarb Loading Dose Phenobarb Loading + Maintenance Nil0
5
10
15
20
25
30
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West Midlands Neonatal Transfer Service
Transfers performedInotropic support
Dopamine
Dobutamine
Dopamine + Dobutamine
Nil
0 5 10 15 20 25 30 35 40