Not all hospitals have the resources for the sickest of babies, infants and
children. In fact in NSW and the ACT, only 10 have intensive care for
babies and just 3 have paediatric intensive care.
Therefore most hospitals need to send their sickest babies and children to
specialist centres for expert care.
During the journey from a country hospital; or even a suburban hospital,
sick children can deteriorate, or even die, during the journey.
Sending an expert clinician from a children's hospital was one way of
reducing this risk. Resuscitation and stabilisation in the referring
hospital by this doctor could be life-saving. However, such personnel are
not always available; given the demands of their own hospital patients.
Published studies showed that the use of skilled assistance prior to
transport improved the chance of survival of premature infants.
In 1977 the foundations of NETS were laid with the construction of a life
support unit for babies at Prince of Wales Children's Hospital and the
purchase of a Ford F250 ambulance by Variety Club to carry this very heavy
In the late 1970's an emergency neonatal transport was developed in
northern Sydney, bringing sick babies from surrounding hospitals to the new
neonatal intensive care at Royal North Shore Hospital.
At the Royal Alexandra Hospital for Children, specific equipment for
transport of babies was purchased in 1978 and, with the assistance of
biomedical engineers, modifications made to permit the equipment to be used
in both road and air ambulances.
In 1979, the first transport of a critically ill newborn baby by helicopter
was made from Taree to Sydney. Unfortunately, the baby later died of a
serious heart condition. This was a prompt to place more emphasis on
providing skilled advice from clinical clinicians to assist doctors provide
better treatment and earlier referral.
In the early 1980s, while the need to move babies predominated, more and
more children were being transported. However doctors were still using
taxicabs as the most efficient way of reaching the child and equipment was
basic and improvised.
1982 saw the transport of a tiny baby born to Australian parents in the USA
and brought back to Australia. The technical challenges of achieving this
task safely were to significantly improve the equipment used within
Neonatal intensive care units in Newcastle and Westmead also developed a
capacity for neonatal transport at this time. As elsewhere, the units
extended themselves to provide staff and equipment to outlying hospitals.
1985 marked the introduction of specialist nurses into emergency transport.
No longer were doctors working without the nursing colleagues they depend
on in the ICU.
In 1989, Child Flight, the world's first dedicated helicopter was launched
to support neonatal and paediatric transport teams in Sydney. The service
permitted transport teams to much more rapidly travel to assist sick or
injured patients. The helicopter permitted one ot two babies to be carried
in NETS life support equipment and at three times the speed of ground
transport. Child Flight operated until 2013 when it was replaced by
CareFlight as the air provider for NETS.
In 1994 it was decided to amalgamate all neonatal and paediatric transport
programs in the state to one location and under one banner. This provided
central coordination and fully dedicated teams to be made much more
available. The 'new' NETS was established in October 1995 in the
geographical Sydney and subsequently moved into a new purpose-built base
with integrated road and air (helicopter) transport, clinical coordination
and team facilities.
In 2007, NETS obtained the legislated status of an 'ambulance service',
enabling the use of dedicated ambulances operated directly by the Service.
In 2008, a satellite service for newborns was formalised in Canberra;
serving the Australian Capital Territory and nearby hospitals in NSW.
A second satellite service in Newcastle was introduced in December 2008
with the launch of a dedicated NETS ambulance for neonatal transports in
In the beginning ...
In the early days, the only component of a retrieval was a doctor. There
was no equipment and no nurse. The doctor travelled by the most expeditious
method; often using a taxi or private car and sometimes a police car or
In 1978 an incubator was purchased and a LifePak 5 cardiac monitor
obtained. The addition of a thermal probe connected to a box with a LED
showing the patient temperature while undisturbed inside the incubator was
a major step forward.
At about the same time, staff from the ICU at Prince of Wales Children's
Hospital (POWCH) developed a neonatal transport system based on a bespoke
ventilator and transported in a specially modified Ford F250 truck donated
by the Variety Club. (P0)
The image shows an early system developed in 1979 at the Royal Alexandra
Hospital for Children Biomedical Engineering and Inhalational Therapy
Departments reduced the size of an ULCO (Campbell) ventilator to fit
underneath the incubator and added a pressure gauge, clock, oxygen analyser
and dual channel temperature display. Both the baby's temperature and
either the incubator or ambient temperature could be measured! At the right
hand end the LifePak 5 neatly sat below the incubator. This system was
dubbed 'RAHC 0' (R0).
In 1980 an Airborne neonatal life support system was trialled at both RAHC
and POWCH. Ultimately, this system became the main unit at POWCH (P1)