From critically ill babies to kids too sick to travel by regular ambulance, specialist medical teams keep children alive in state-of-the-art mobile intensive care units, both on the road and in the air.
The oxygen mask makes her cry. the sound is drowned out by the roar of the helicopter passing over pine forests and paddocks recast as housing estates. She’s strapped on a stretcher, blanket over her bare skin and looking up in tears to her mother, who tries to distract her by pointing out the window and fashioning her hands like little birds flying away.
Megan Anderson tries Incy Wincy Spider, too, making her fingers rain while mouthing the words. She is seated too far from her daughter Lucy to hold her. A tear trundles down the two-year-old’s left cheek. “She’s looking at me and her eyes are pleading, saying, ‘What are they doing to me? What’s going on?’, ” Anderson says.
Nurse Jenna McGeever looks over a patient. Photo: Tony Walters
Between them in the cabin are paediatric emergency doctor Adrian Bonsall and nurse Charlotte Moore, monitoring Lucy’s heart rate, temperature and oxygen. The child, pale and feverish with plump lips and thick curly hair, looks at them with eyes wide.
The initial call for help to the Newborn and paediatric Emergency Transport Service (NETS) came from central-west NSW’s Bathurst Base Hospital two hours ago, at 9.55am. Lucinda Hunter, less than a month shy of her third birthday, was admitted overnight with a viral infection and low levels of white blood cells and haemoglobin. She is sick and lethargic and in need of specialist care. “I hate these calls. You know the parents’ world is about to be turned upside down,” says NETS retrieval nurse Catherine O’Farrell.
Minutes later, Bonsall and Moore are on the helicopter pad atop Sydney’s Westmead Children’s Hospital. It is an overcast and chilly Monday morning.
Jacqui Sansom and Jason Moran watch NETS doctor Ben Lakin tend to their daughter, Allira. Photo: Tony Walters
During the 45-minute flight to Bathurst, Bonsall, a softly spoken former computer programmer with neat, greying hair, runs through the best- and worst-case scenarios. “There are possible infection issues with this child, so she can become unstable,” he tells me.
We arrive at Bathurst Base Hospital to find Lucy in bed watching TV. Anderson strokes her daughter’s hair and rubs her leg through the sheet. Bonsall checks Lucy’s X-rays and shines a torch into her eyes. Lucy wails as Anderson rolls her on her side, so the doctor can check her heart beat. “It’s hard with children sometimes,” Moore says. “They don’t understand what’s going on and you can’t explain it to them.”
There are more tears as the NETS team moves Lucy on to a trolley. “Don’t cry, don’t cry,” Anderson says, kissing her on the forehead. “We’re going on an adventure.”
A NETS team unloads equipment in Mudgee. Photo: Tony Walters
Later, back at Westmead, Lucy will be diagnosed with leukaemia. Now, as her daughter is wheeled towards the helicopter in Bathurst, Anderson is hugged by a hospital nurse. “You’ll be all right,” she tells her. “Remember, one day at a time.”
Before NETS started in 1979, sick babies and children were shifted by road ambulance or sometimes by air or, more likely, not at all. “We would put ourselves in a taxi and our medical equipment in the boot and try to get to the hospital and treat the child as best we could,” says NETS state medical director Andrew Berry. “It was pretty Wild West … Before NETS, a lot of these children would not even leave to go to a bigger hospital or some would die along the way.”
The statewide medical retrieval service provides clinical triage for critically ill newborns, infants and children too sick to travel by regular ambulance. NETS is a hospital without walls, covering NSW and the ACT and beyond – some patients have been brought home for care from as far away as London and New York.
Saftey NETS: A NETS chopper lands at central-west NSW’s Mudgee Hospital. Photo: Tony Walters
NETS transfers about 2700 sick babies and children a year to hospitals providing specialist neonatal and paediatric care. One in 49 people in NSW will travel with NETS during their childhood. Outside Sydney, it is one in 38. “In every classroom or two, you will find there is someone whose life has been changed by NETS,” Berry says.
A similar service in Victoria, known as PIPER (Paediatric Infant Perinatal Emergency Retrieval), transported about 1200 newborns from regional hospitals to Melbourne last year.
About 12 calls a day are made to NETS, each one sounding a high-pitched alarm at their base at Westmead Hospital. Southern Sydney’s St George Hospital calls concerning a baby that is 30 hours old and struggling to breathe. A child in the northern NSW town of Casino is sick with asthma and screaming, her struggle shown via a new video network system. A NETS retrieval team flies to Glen Innes, in the state’s New England region, where a baby is having seizures.
NETS ambulence driver Bruce Dalziell unloads a neonatal life-support system. Photo: Tony Walters
At 7.43am one Wednesday a call comes from Bathurst Base Hospital, where a mother has had an emergency caesarean after haemorrhaging her placenta. “The mum and bub lost a lot of blood. This is as serious as it gets,” Berry says.
A helicopter is dispatched with a NETS retrieval team to bring the baby, with her father, to Sydney’s Nepean Hospital for specialist care. Dad is wearing a T-shirt and long shorts. His new daughter’s hair is matted and still bloody from birth. Her name is Sophie, he says. Doctor Pradip Patel reaches into the neonatal life-support system to touch her leg. “She’s not cold,” he says. “But she is very sick, very lucky to be alive at the moment.”
The NETS team covers the crib in a baby’s blanket to protect Sophie from the sun as they enter Nepean Hospital. They ensure she is stable before handing her over to staff. Patel rests his hand on her head. “She’s lovely, absolutely lovely.”
However, despite the best efforts of medical staff, Sophie dies soon after. “In each case you ask, ‘Does this child only have seconds to live, minutes, hours – what can I do to save their life?’ ” Patel says. “I don’t think anybody could have done more. Unfortunately, it was just one of life’s cruel ways.”
A month later, by chance, he is called out to Bathurst to transfer Sophie’s 18-month old sibling to Sydney with severe croup. The child survives.
bruce dalziell speeds through friday afternoon traffic with the flashing lights on. It is surprising how many cars stick to the right lane of the freeway towards Newcastle. Truck drivers are the worst, he says over the sound of the sirens.
NETS driver Dalziell has shaggy hair and seven tattoos. Sick children like looking at the markings, he says. “I try to talk to the younger kids so they don’t get traumatised,” he says.
Dalziell has four children of his own; the youngest is 22. “It’s best not to treat a patient as one of your own,” he says. “If it is one of your own, you will do everything for them. But you need to be more vigilant with what you do on the job because of the other people in the ambulance. Otherwise, you just lose your senses.”
Fifteen-week old Allira Moran is at Newcastle’s John Hunter Hospital, asleep and sucking on a dummy. Her father, Jason Moran – still dressed in his forklift driver’s uniform – rests his right hand on her head.
Jacqui Sansom stands behind him, looking across their daughter to the line of hospital machines. “She’s been good until today,” she says. They were at a school Harmony Day parade for another of Sansom’s children, when Allira’s lips turned blue.
Allira was diagnosed with a congenital heart defect while still in the womb. Now her parents stand back as the NETS retrieval team of doctor Ben Lakin and nurse Joanna Ireton step in to treat their daughter. They are calm and unhurried despite the insistent beeping of machines. Lakin checks her X-rays and vital signs.
Ireton tapes down the tubes that run into Allira’s nose before a helicopter arrives for the journey to Sydney. Moran sits beside me and we watch the moon while flying over the ocean to Sydney Children’s Hospital, where Allira is rolled into a ward.
Three weeks later, Sansom is waiting with her daughter in the hospital ward with their bags packed to go home. Allira is in pink love-heart pyjamas next to a teddy bear that has been signed by her anaesthetist: “You worked me hard. Love John A.”
Sansom shows me a mobile phone photograph of Allira after open-heart surgery, hooked up to several tubes with an angry scar down her small chest. In weeks to come, it will fade to a light pink and Allira will start sitting up and gaining weight again.
Looking at the photograph, Sansom still struggles to contemplate how close her daughter came to death. “I lost both my parents and a former partner and they were hard enough. I couldn’t imagine losing a baby,” she says.
“With Mum and Dad, they had lived their life – a baby hasn’t. They haven’t … haven’t had that chance.”