Neonatal Critical Care Transport Program
The Stanford/LPCH Neonatal Transport Program began in 1970 with the development of a regional perinatal access program that initially covered all of Northern California . Transport of critically ill infants longer than 30 minutes was not feasible because of the inability to provide life support and an adequate thermal environment. At the same time, there was clinical evidence that the transport of such infants led to a significant reduction in morbidity and mortality. The unique challenges faced in setting up a program to transport critically ill infants, and older patients, intrigued anesthesiologists at Stanford and led to their involvement in it. After an initial non-funded period with interfacility transports carried out by faculty only, a federal Regional Medical Program grant was obtained. Requirements for surface, air and rotor-wing ambulance carriers and operators were established. A perinatal outreach program was created with the main goal of training health care providers in community hospitals in neonatal resuscitation and pretransport early care of critically ill infants. Recuitment and training of physicians, nurses and respiratory therapists who would become transport team participants began. 25% of referrals for transport could not be accepted by the first neonatal intensive care unit called. At that time, 25% of referrals for transport could not be accepted by the first neonatal intensive care unit called. A resource management center (dispatch/communications) center was created connected to a newly formed regional network of neonatal intensive care units. A neonatal transport incubator was developed in partnership with the Department of Mechanical Engineering in the Stanford School of Engineering to allow intensive care in a thermoneutral environment.
The program expanded and became a national model. A mutual relationship with a similar program in Paris , France led to advances in both. In 1976, legislation was passed at the State level, with the support of the March of Dimes, setting requirements for participating hospitals in the California Perinatal Dispatch Center System, now called the California Perinatal Transport System (www.perinatal.org), and providing funds for it. A second State funded program was passed, the Regional Perinatal Programs of California, establishing a regional network of perinatal outreach programs. This legislation led to expansion of the regional transport programs to include high-risk maternity patients. Several years later, pediatric and adult components were added to what is now called the Packard pediatric and Stanford adult critical care transport systems. Finally, in 1984, the Stanford LifeFlight program was added. Faculty and residents in the Department of Anesthesia have been, and still are, involved in these activities.
In 1975, the longest Stanford neonatal transport was performed when an infant with tricuspid atresia was transferred by a Stanford team from Hong Kong to Stanford.
