The equipment used in transport must comply with several general characteristics:
• Appropriate for the age group and for the health problems to be managed.
• Lightweight, portable, rugged and easy to clean
• It must be securely fastened in the transport vehicle for patient and equipment safety.
• Tested in transport conditions (temperature, altitude, vibration).
It is essential to have equipment that allows for:
As efforts to improve the outcomes of neonatal survival are scaled up, there is an increased demand for access to safe and effective transport.
Improving the procedures related to neonatal transport and the quality of care in critical conditions requires evidence-based technical guidelines as a reference for agencies, facilities, and health professionals responsible for setting health system priorities and policies around newborn transport.
Regionalization poses the challenge of defining where to assign resources to intensive care, transport or prevention and primary care.
Neonatal transport should be seen in the context of regionalized perinatal care, which encompasses the care of the pregnant woman and her fetus, the mother-to-be and her baby.
Universal newborn hearing screening (UNHS) with otoacoustic emissions (OAE) or automated auditory brainstem evoked potentials (ABEP-A) testing is recommended for early detection of permanent bilateral hearing loss (PBHL). UNHS should be accompanied by diagnostic and treatment services for infants in whom hearing loss is detected.
Applying emollient or moisturizing creams or any other product on the skin of newborns is not recommended.
At birth, human skin is covered with an acid mantle, which is key to maintaining the baby’s defenses. Although there is no scientific evidence about the harmful effects of emollients, no benefits have been demonstrated in their application.
Therefore, it is not recommended to apply emollients or other products on the skin. If in doubt, it is always advisable to ask your health care team.
Routine application of topical emollients is not recommended for the prevention of skin conditions in healthy full-term infants.
This recommendation was developed by the WHO Guidelines Development Group (GDG). The GDG agreed that there was insufficient evidence on the beneficial and harmful effects of routine application of topical emollients on healthy term newborns to prevent skin conditions such as atopic dermatitis, dry skin and others.
Before organizing a neonatal transport system, there needs to be planning and coordination at the national and regional levels to align transport goals and objectives with those of the health system as a whole.
The planning process includes:
• Alignment of the objectives aimed to improve health system outcomes and transportation priority cases (and cases excluded).
• Estimation of the demand for care for each health problem selected and per region (met and unmet needs).
Universal screening for neonatal hyperbilirubinemia with transcutaneous bilirubinometer (TcB) is recommended at the time of discharge from the health center.
Physicians should ensure that all newborns are systematically monitored to rule out the potential occurrence of jaundice during the stay in the health center.
The postnatal age for universal TcB screening at discharge should be based on when the baby is discharged from the health center.
Gentle full-body massages are recommended for full-term newborns for their potential growth and developmental benefits.
Gentle stroking and massage provide an opportunity to stimulate infants and interact with them.
Reactions to massage should be respected according to the principles of tender and sensitive care.
It is recommended to consider gentle whole body massage for healthy full-term newborns because of its potential benefits for growth and development.
Gentle whole body massage involves the use of the hands for tactile stimulation, slowly rubbing and stroking parts of the body or passive full range movement at the joints of the extremities.