Neonatal Flights – Sudden Births & Unexpected Arrivals

The Real Doc Martin – Capital Air Ambulance’s Devon based Medical Director Dr Terry Martin – gives a snapshot of the service’s response when babies decide to arrive unexpectedly.

It’s not an unusual scenario. A young couple, happily expecting their first baby, and fully aware that life will change completely and permanently in a few months’ time, decide to take one last long holiday in the sun ‘while they can’.

She’s 27 weeks in to a normal pregnancy, and he’s making sure she has a great holiday and books his lovely wife on to all the excursions and adventures that are on offer at their resort. Who said that holidays are restful? Here the scenario changes significantly, and the story unfolds.

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After a night out at a wonderful romantic restaurant, she wakes in the early hours with ‘stomach ache’ aka abdominal pain of unknown origin in a primigravida (lady in her very first pregnancy) in the early third trimester of her otherwise normal pregnancy.

The realisation takes a while to dawn before they decide this may be a premature labour. A flurry of activity, some blue lights and sirens, and soon the diagnosis is confirmed. Obstetric nurses, midwives, an obstetrician and an anaesthetist all come to try and stop this baby arriving too early for its own birthday. But this baby boy is determined and drops in to the world almost 13 weeks earlier than expected.

Unfortunately the new baby is not yet quite prepared for independent living! He isn’t too keen on the harsh dry environment of the neonatal incubator that very quickly become his new home, and prefers to be in mum’s own incubator!

On top of that, mum and dad are not too pleased that junior has arrived at a time when he is so small and so immature that almost every one of his functions of living are not yet developed enough to exist outside of this bubble. This is what being premature is all about.

A second flurry of activity starts after dad learns that flying baby home on their Easyjet special is simply not possible. Baby needs time to mature, time for the lungs to work efficiently, time for growth and weight gain, time to reduce the risks of infection, intracranial bleeding, and of inability to control his own temperature, to name but a few.

Did we take out insurance? Does it include cover for premature labour? Exactly what costs will be covered? How and when can we go home?

It’s not that much of an unusual scenario.

Capital Air Ambulance has been very successfully transporting adult patients for 6 years between all parts of the world, but often back to the UK. In the past two years, our contract with the Channel Islands has brought ever increasing requests to move premature babies and other neonates with urgent need for specialist paediatric or neonatal services. This demand grew as our equipment, personnel and capabilities developed in parallel to deliver the best possible neonatal transfer service for the islands of Jersey and Guernsey.

At the same time, the fund-raising children’s charity LUCY Air Ambulance sought our help to be their provider of aviation and aeromedical services for the transport of children around the UK. Ultimately the coincidence of timings of these major events encouraged us to build a highly flexible and robust neonatal transport service with state of the art equipment and highly trained specialist personnel.

We are now pleased to update our followers, but specially our clients and partners, that Capital has met its aims, and now proudly operates a fully equipped neonatal transport and retrieval service, using neonatal nurses and consultants from around the south of England, trained by us to act as flight medical crew. In doing so we were extremely fortunate to have attracted a very experienced clinical lead for the service. Dr Faith Emery recently joined my medical team at Capital and comes with a strong history of neonatal transport expertise, much of which was on international flights.

Our neonatal service still gathers plenty of experience with its cross-channel work for the islands of Jersey and Guernsey but, under Faith’s expert management and hands-on control, we have already undertaken two international neonatal transfers in the past few weeks This increased capability, coupled with a dedicated quarterly training program to recruit even more neonatal nurses and doctors has been strengthened by Capital’s fleet of three aircraft types of which each have a specific advantage depending on whether the transfers are island-hopping, within national boundaries, or from Europe or further afield.

With leadership from Dr Faith Emery, support from all of Capital’s resources and our state of the art equipment, Capital looks forward to a long lasting relationship with the LUCY charity and to transferring premature and neonatal babies for our many clients and partners who have, up to now, loyally used our services only for adult patient transfers.

As to the rather surprised new parents whose story we began with… baby Julian slept through almost the entire journey to the UK and was finally discharged from hospital to go home for the first time with mum and dad a few days ago. His hospital stay was peppered with a few ups and downs, and, like all premature babies, he will need close follow-up in the months ahead, but his future looks great and his parents are so happy with their bonny early delivery.