An ambulance is often viewed as a cocoon of safety, but for premature infants with very low birth weight (VLBW), this may not be the case. When needed, VLBW infants are transported to specialized care facilities. Ambulance use, although necessary, has jarring effects and loud noises that can cause physical stress, potentially leading to compromised health and development.
“We want to create a smooth and quiet ride, and did this by evaluating sound and vibration in the incubator. It seems simple, but nobody has done it before,” said Dr. Judith Prehn, pediatric physical therapist at The Children’s Center for Communication and Development at The University of Southern Mississippi. “The norm is to put VLBW babies in the same transport incubator as the other babies with no special treatment.”
Prehn looked at reducing sound and vibration during ground ambulance transport of preterm infants weighing 3 pounds. Prehn worked closely with Terri Daniels, director of the Neonatal and Infant Development Program in the Southern Miss College of Health. Collaborators also included assistant professor Dr. C.G. Marx and associate professor Dr. Ed Goshor of the Department of Speech and Hearing Sciences.
“Since 2001, Judy and I have worked collaboratively with Dr. Clint White and the other neonatologists at Forrest General Hospital to implement developmentally supportive practices as part of the traditional medical care in the neonatal unit,” said Daniels. “Expanding the same considerations to ambulance transport of the infant was a natural next step.”
An accelerometer, a device used to measure vibration and motion, was placed inside an infant model to measure impact during transport. By measuring and comparing different mattresses and mattress material combinations, the team determined which modifications provided the smoothest ride. Measurements were taken while driving an ambulance down an airport runway.
“The accelerometer showed that the mattresses that worked best for the 4-pound mannequins did not work best for the 3-pound models,” said Prehn. Her research findings will be published this fall in the international Journal of Perinatology.
The partnership between the College of Health’s Neonatal and Infant Developmental Program and Forrest General Hospital’s Neonatal Intensive Care Unit has resulted in the development of trainings and materials used in more than 30 countries.
“The neonatologists use the support from USM to study published research and monitor recommendations in the field of developmentally supportive practices,” said Daniels. “For example, we have been asked to research the best developmental feeding practices, or research on light exposure to infants. Judy and I review the literature or talk with researches to determine current best practices, and then we partner with the medical staff to implement those in the NICU.”
“Our partnership is considered a leader in the field of developmental care,” said Daniels. “Due to the complexity involved in researching vibration in ground ambulance transport for preterm infants, the findings of this study will likely be used by community hospitals to improve care of neonates.”
Prehn looks ahead to future research areas. “What we need to look at next is what mattress combinations work best for other weights, such as a 2-pound infant. What we really need to look at is sound transfer from the ambulance to the incubator cart frame, and even consider re-designing incubators.”
To learn more about the College of Health’s Neonatal and Infant Developmental Program, visit www.usm.edu/health/neonatal-and-infant-developmental-program. For more about The Children’s Center for Communication and Development, visit www.usm.edu/early-intervention-childrens.