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 unit.
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 Australia.
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 the Hunter.
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 commercial airliner.
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)