Assessment of Physiological Stability and its’ Effects on Neonatal Morbidity and Mortality for Newborns Transferred by Ambulances to the Neonatal Intensive Care Unit at Caritas Baby Hospital in Bethlehem رسالة ماجستير

Abstract

Background: In the west Bank, limited specialized neonatal transport services result in infants being transported in inadequately equipped ambulances without medical expertise. This increases neonatal mortality and morbidity risk due to delayed access to proper medical care. Understanding these risks is crucial for developing interventions to enhance neonatal transport and care in resource-limited and hard-to-reach areas. Objectives: The study aims to assess the physiological stability and its effect on neonatal mortality and morbidity for newborns transported by ambulances to the neonatal intensive care unit at Caritas Baby Hospital, using the TRIPS score, ABGs, and Blood sugar. The TRIPS score tool was used to comprehensively to assess vital signs, response to stimuli, and respiratory function of transferred neonates. The research seeks to understand the issues concerning ambulance preparedness and the safety of neonates during transport. Methodology: This retrospective cohort study analyzed data from medical records in a health information system (HIS) for newborns admitted to the neonatal intensive care unit at Caritas Baby Hospital (CBH) for the year 2021. The study focused on infants aged 0-28 days transported by ambulances. Descriptive variables such as age, sex, gestational age and weight, and physiological measurements were examined, the Transport Risk Index of Physiological Stability Score (TRIPS) assessed parameters including temperature, respiratory work, systolic blood pressure, and stimuli response, in addition to blood sugar readings and ABGs results on admission. A purposive convenience sample of 96 records was selected based on their relevance to study objects. VI Results: Significant correlations were found between TRIPS score and gestational age, weight, and ABGs findings. Higher TRIPS scores were linked to greater physiological instability, temperature, and respiratory work varied significantly with gestational age, and males exhibited higher respiratory work. Conclusions: Higher TRIPS scores were associated with greater physiological instability, highlighting the urgent need for improving ambulance preparedness and neonatal transport. Addressing these challenges is crucial for improving neonatal care in areas with limited specialized transport services