Indications for Air Medical Transport Activation

Consider Air Medical Transport in:

• Respiratory distress requiring intervention (O2, N-CPAP, Intubation) regardless of cause (MAS, sepsis, RDS, CHD, etc.) Any infant with any suggestion of airway compromise or respiratory failure should be considered a transport candidate.
• Any unstable airway (choanal atresia, mass, congenital anomaly Pierre Robin, Treacher-Collins).
• Any infant with a distended abdomen with unknown etiology, or suspected surgical abdomen (Hirschsprungs, atresia, NEC, congenital abnormalities).
• Infant with known / suspected cyanotic heart disease.
• Infant with congenital heart disease resulting in decreased systemic output such as Hypoplastic Left Heart, Coarctation (suspect in poor perfusion, increasing metabolic acidosis, decreased or absent pulses +/- heart murmur).
• Infant with congenital heart disease resulting in symptomatic congestive heart failure (increased respiratory rate, enlarged liver, poor perfusion, "wet" chest x-ray, and large heart on chest x-ray).
• Birth weight < 2000 grams and/or gestational age < 32 weeks.
• Seizures not responsive to routine treatment (phenobarbital/phenytoin).
• Any infant with unstable vital signs
  (i.e. or HR, RR, or To, BP)
• Suspected unstable metabolic conditions, such as inborn errors of metabolism.
• Any infant on pressor agents, prostin or with symptomatic arrythmias requiring treatment.
• Any infant requiring immediate and/or rapid transport in the referring physician's opinion.

Consider the following when assessing newborns:

• Infants with significant asphyxia are at risk of seizures, and resultant apnea.
• Full term infants with significant asphyxia or compromise during or immediately after birth, may be at risk of developing persistent pulmonary hypertension of the newborn (PPHN).
• Infants with a PCO2>60 and requiring greater than 40% oxygen should be considered candidates for intubation.
• Sepsis should be strongly considered a factor in any compromised newborn.