Libro blanco de las ACES Pediátricas 2024

Libro Blanco de las ACES Pediátricas 2024 502 ❚ 28 maternal transfer of high-risk pregnant women to the perinatal centre and to avoid the postnatal transfer of preterm or sick infants. Information documents for referring hospitals and pregnant women should be available, as well as prenatal transfer facilities for pregnant women. Neonatal transport: Each training unit accepting neonatal referrals should have, or have access to, an appropriately staffed and equipped transport service. When a doctor or a nurse is absent from the unit whilst transporting a baby there must be satisfactory arrangements to cover their duties. Equipment Each unit providing training in Neonatology should have a policy prepared in consultation with the technical service centre and agreed with the hospital management. There should be a budget for the purchasing, maintenance, replacement and upgrading of equipment for neonatal care, which complies with national standards. Such a policy should also extend to appropriate record keeping for usage of equipment and quality assurance in keeping with good laboratory and clinical practice. Each neonatal intensive care cot in a training unit should have available the following: Incubator or unit with radiant heating, mask and bag or T-piece, ventilator with humidifier, syringe/infusion pumps, monitors for respiration, heart rate, blood pressure, transcutaneous or intra-arterial oxygen tension, oxygen saturation, and ambient oxygen, inhaled nitric oxide and facilities for providing therapeutic hypothermia, and if available, also aEEG and NIRS cerebral oximeters. There must be access to equipment for resuscitation, point-of-care blood gas analysis (on the neonatal unit, by unit staff), phototherapy, transillumination by cold light, portable x-rays, ultrasound scanning, expression of breast milk, transport (including mechanical ventilation), and instant photographs. Access to a video-laryngoscope would be desirable. There should be access to a 24-hour laboratory service with micro-technique orientated to neonatal service needs. Quality assurance Clinical protocols: Each training site for Neonatology should have agreed written protocols (standard operational procedures, SOPs) for medical and nursing staff, which also contain details of practical procedures as resuscitation and management of extremely preterm infants. These protocols should be regularly reviewed through discussion and audit. Monitoring clinical practice: There should be monitoring systems for short- and longer-term morbidity among survivors with plans for regular review; including protocols for cerebral ultrasound examination, screening and treatment for retinopathy of prematurity, and screening of high-risk survivors for hearing loss. A minimum data set to form the basis of an annual report should comprise the following items, stratified by birth weight and gestational age: the number and duration of admissions should be classified according to international guidelines; the numbers of mothers and infants transferred to and from that maternity unit for care; mortality before 28 days and before discharge from hospital classified by cause; number of infants receiving ventilatory support and duration, post-mortem examination rate. Assessment of training centres and trainers