Transport service helps provide best outcome for critically ill babies in southern Alberta

Click to play video: 'Calgary-based transport service helps provide best outcome for critically ill babies in southern Alberta' Calgary-based transport service helps provide best outcome for critically ill babies in southern Alberta
The Southern Alberta Neonatal Transport Service helps save the lives of hundreds of sick and at-risk newborn babies by providing critical care during quick and safe transports between health care facilities throughout southern Alberta. Deb Matejicka reports – Nov 13, 2020

When minutes can mean the difference between life and death, the Southern Alberta Neonatal Transport Service (SANTS) is there for critically ill newborns.

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“If we weren’t able to have her moved quickly — and then be able to stabilize her quickly — she wouldn’t have survived. Not a chance.”

Kristine Russell said her daughter Ellie received life-saving transport just hours after her birth.

Both mother and daughter went into septic shock, with little Ellie’s condition deteriorating quickly.

The hospital in Medicine Hat where she was born wasn’t equipped to deal with her level of illness so doctors called the SANTS team.

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Russell knew the hospital could accommodate an air transport for Ellie but what she didn’t know was that the team that would help save her daughter’s life was made up of a transport-specialized trained nurse and respiratory therapist.

The team was also well-equipped with life-saving equipment made specifically for neonates.

“I didn’t realize that the team actually came from Calgary,” Russel said.

“It was a specialized team that would come in and actually take her.

“They would switch all of her machines, they would intubate her with their equipment, they would move her into their isolate.”

Neonatologist Dr. Sumesh Thomas has been running the SANTS team since 2013 and has never stopped working to improve and streamline the service.

“It’s one thing to care for relatively older folk like myself, but at the start of life, the potential is immense, the risks are substantial,” Thomas said.

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Based at the Foothills Medical Centre, SANTS deals in high-risk transfers of critically ill infants from as far north as Red Deer to as far south as the U.S. border, stretching east and west to the borders of Saskatchewan and B.C.

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“It is the mechanism that ensures that babies access the right facility at the right time with the right resources,” Thomas said.

Most hospitals in the province fall into one of three levels based on the skill and expertise of the doctors working there and the equipment and resources available at the facility.

So when a baby is born at a Level 1 facility but needs Level 2 care, the SANTS team can be called in to get that baby safely and quickly to the nearest facility with the appropriate level of care.

The team is on call 24/7 and within just minutes of receiving a call, they will mobilize and make life saving decisions on the care that is needed, the closest facility that can provide that care and the equipment they will need during transport. The team aims to be en route within 15 minutes, whether that’s by air or ground.

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“Interventions that are timely and effective can make the difference between lifetime of disability or lifetime of normality,” said Thomas.

“For these small and vulnerable babies… access to high skill levels and resources are critical in terms of both their survivability, but more importantly, their functional outcomes in the future.”

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Thomas has also implemented other changes during his tenure to ensure southern Alberta’s sickest and tiniest patients are getting the best care possible.

He connected SANTS to a central hub that handles all requests for care, which has helped make response times even quicker. He has also worked closely with a larger team to provide telehealth services in regional facilities like Taber and Pincher Creek.

“So that’s an additional piece of informatics that helps us to actually lay eyes on the patient, although we are several hundred kilometers away, and support these physicians in delivering care,” Thomas said.

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Thomas and several of his colleagues have also made the commitment to visit different regional facilities each month to meet face to face with physicians there to run simulation exercises and to discuss contemporary care and strategies that are being used at the Foothills and in other perinatal facilities.

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“You can write whatever policy and guideline you want, if it doesn’t have people and if it doesn’t have that personal connection, essentially, these things will not work well,” Thomas said.

“And so the outreach education program was geared at trying to enhance the collaborative function of the perinatal network.”

The changes made with SANTS have had an overall positive effect on the success of the service and the outcomes for its patients.

A recent publication of its services points to a significant reduction in death and brain injuries among babies with birth asphyxia who were born in regional facilities since the outreach education program started .

“These endeavours are not without substantial gains, in terms of health care costs,” Thomas said.

“There’s nothing more priceless than the life of a child who is able to live a normal life and you can’t put a dollar value on it.”

Each year, the lives of approximately 600 infants, many of whom are born severely premature, fall into the hands of the SANTS team, which is funded solely by donors via the Calgary Health Foundation (formerly the Calgary Health Trust).

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