The reach of St. David’s HealthCare, an eight-hospital healthcare system in Austin, Texas, goes well beyond its community. Through the St. David’s Specialty Transport Team, which uses multiple modes of transport — from ground to fixed-wing and rotor — the Central Texas-based healthcare system serves patients from all over the state who are in need of a higher level of care than is currently available in their region.
Like most neonatal teams who utilize multiple modes of transport, the St. David’s Specialty Transport Team has separate transport incubators for fixed- and rotary-wing missions. When missions require the use of a helicopter, the St. David’s Specialty Transport Team partners with Travis County STAR Flight to provide neonatal and high-risk obstetric transport services throughout Central Texas and beyond.
When Travis County STAR Flight recently purchased three Leonardo AW169s — configured for medical transport, search-and-rescue, and fire suppression — the St. David’s HealthCare team discovered an opportunity to standardize their transport incubator configurations across all modes of neonatal transport, thereby creating a universal transport incubator.
Several years ago, St. David’s HealthCare became the first in the Central Texas region to offer a hospital-affiliated fixed-wing ambulance aircraft service for timely transfer of emergent and acute care patients. This service laid the foundation for the later development of the universal transport incubator. While the mode of transport can vary across missions, ground transport is a part of every fixed-wing mission.
Historically, the ground leg of a fixed-wing air transport was challenging, and included managing multiple variables: varying ambulance cots, different ambulance locking systems and third-party EMS crews. Neonatal specialty transport teams dependent on their transport incubator systems would often struggle with securing their transport system to an unfamiliar, non-compatible ambulance cot. With this challenge, it wasn’t uncommon for transport teams to be forced to use straps to secure their transport incubator while traveling to and from the hospital, which could potentially shift during transport, creating a risk to both the patient and members of the transport team.
Recognizing this potential hazard, St. David’s HealthCare adopted the use of International Biomedical’s Certified Litter Interface Platform (CLIP) Deck to create an airborne transport incubator that could safely transport babies across both ground and fixed-wing modes of transport. The CLIP Deck is a unique adaptor for ambulance stretchers that allows the transport incubator configured for fixed-wing transport to be secured safely in the ambulance during the ground portion of the transport.
Working with STAR Flight, the St. David’s HealthCare Specialty Transport Team discovered an opportunity to extend the use of the stretcher adaptor to rotary-wing aircraft by using a pre-existing sliding lock within the interior of the aircraft that accommodates the footprint of a transport deck sled. With this accommodation, St. David’s HealthCare was able to create a truly universal transport incubator that could safely transport babies across all modes of transport: ground, fixed-wing and rotor.
On Aug. 15, 2019, St. David’s HealthCare was dispatched on its first NICU rotor mission in STAR Flight’s new aircraft, successfully completing its journey with a universal incubator. This is not only an accomplishment in terms of safety for both the patient and the clinical team, but it also gives St. David’s HealthCare the versatility to change modes of transport seamlessly mid-mission, should operational challenges such as weather, mechanical failure or pilot fatigue occur, the organization said.