Click here to go to NETS home pageContacting NETS

Any clinician can contact NETS on the NETS Hot Line (1300 36 2500). Call cost are at local call rates from within Australia. Calls to the NETS Line are answered immediately. A list of options is presented and callers are reminded about the fact that calls to NETS are recorded. Option 1 (for emergency retrieval) is answered by the duty 'clinical coordinator' who connects the caller (in conference mode) to the duty consultant — and then other specialists, as required. A diagram illustrates the process. Details are entered on a case sheet and a voice recording of the call is made.
There are clinical criteria for calling NETS. As well, children's hospitals have age limits beyond which an adult hospital may be a more appropriate destination.

A single phone call is all that is required to activate the process of retrieval. The same hotline allows callers to reach:

  1. Any tertiary referral obstetric Unit relevant to NSW hospitals.
  2. Clinical advice from a feto-maternal specialist.
  3. Booking an 'elective' retrieval.
  4. Adult retrieval.
  5. NETS office.

There are policies for this process.

Should images be available to supplement the consultation, these can be sent. For details, please see the TeleMedicine page.

An immediate response by a clinical NETS team is normally possible. The team is despatched by one of the dedicated fleet of road ambulances operated by NETS or a helicopter operated by Child Flight. NETS also has access to fixed wing air ambulances (turbo-prop and jet) for long distances. Other helicopter operators provide transport for teams in periods of high demand.

Alternatively, discussion can occur with appropriate senior clinicians to assess the best course of clinical action. Neonatal or paediatric intensive care specialists, fetal obstetricians, paediatric surgeons and cardiologists are available to participate. Sometimes, this clinical discussion can make transfer unnecessary or safely delayed until the patient's condition is more appropriate for transfer.
Treatment instituted as a result of active telephone management at this time can often materially affect the outcome. A decision for hasty transfer in the hope that the patient will 'survive' the process enough to be resuscitatible at the destination is a bad (and unnecessary) one.
The NETS team comprises a transport nurse (CNS or RN grade) and a transport doctor as a minimum team configuration. Nurses are permanent members of the service and registrars are from the general paediatric, PICU, NICU or anæsthetics training programs. There is a capacity for an additional one or two members of the team for training, accreditation or observational purposes. For a referring hospital to spare an appropriately skilled person to escort the patient may compromise the cover at that hospital for other events. Sending a junior member of staff (who may be the most 'easily spared') puts the patient at risk and imposes a professional challenge to the escort which may be destructive to the learning process.
The team spends an average of 90 minutes stabilising a newborn patient and 60 minutes with a child. This involves starting intensive care treatments - as if the patient were already in a specialist centre. There are 10 neonatal intensive care units in NSW and the ACT and 2 pædiatric intensive care units. By way of contrast, there are many more (around 40) intensive care units for adults. This difference in the degree of centralisation accounts for the large number of babies and children needing medical retrieval. Most adult intensive care units (many of which are in country areas) can deal with sick adults. There are no intensive care units for babies or children in country areas. Lastly, for older patients with trauma, 'hospital bypass' selects a more appropriate initial hospital location for many patients. This may avoids the need for retrieval.
Finally, the patient is transported to a suitable hospital where intensive care can continue.
When required, a second patient can be transported in an aircraft. A second patient in a ground vehicle requires a separate vehicle for each patient.
NETS seeks information about outcomes of all patients about whom calls are logged, whether they are transported or not. This is obtained from those destination hospitals to which patients are transported. There are also outcome databases kept in the destination hospitals of all patients who reach neonatal or paediatric ICU. 
There is a training program for all doctors working with NETS. A sample weekly program is shown.