Marcelline D1, Steere M3, Adams D1
1Central Australian Retrieval Service, 2NT Health, 3RFDS SA/NT
Biography:
Dr David Marcelline is a FACRRM Rural Generalist from Central Australian, currently working between the Central Australian Retrieval Service and Alice Springs Hospital Anaesthetic and Emergency Departments. Previous roles have seen David working across the Northern Territory, providing primary and secondary care at cattle stations, remote community clinics and rural hospitals. David has diverse interests that include paediatric care and is an instructor with APLS and the locally provided CART course.
Abstract
Alice Springs is the hub for primary retrievals across a 1.6 million km² catchment, served by a combined CARS and RFDS team. The population centres within this catchment are small, spread out and variably serviced by healthcare. The population serviced tends to be younger, more fertile and socioeconomically diverse, leading to challenges with routine travel, healthcare engagement as well as healthcare priorities. This manifests as a significant increase in obstetric related retrievals compared to national averages, with a significant number of these being labouring women. Unfortunately, the Alice Springs catchment does not have a dedicated neonatal transfer service, which means we have had to adapt and innovate to ensure provision of appropriate care, so we need to be able to provide prehospital midwifery and neonatal resuscitation care. As per ILCOR and ANZCOR guidelines, neonatal care and resuscitation should be provided stepwise; with provision of continuous positive airway pressure (CPAP), intermittent positive airway pressure (IPAP) as well as incremental supplemental oxygen commencing from room air. The luxury of compressed medical air and a gas blender is difficult to achieve in a non-dedicated neonatal asset, so workarounds to provide best possible care are required. This presentation will demonstrate the use of a turbine driven transport ventilator to provide blended oxygen to an appropriate neonatal interface, both a familiar T-piece product as well as an Ayre’s T-piece with Jackson Rees modification.