Mobile ICU unit that saves kids

It ferries critically-ill children who need medical support to hospital

Some members of KKH’s Chets team (from far left) assistant nurse clinician Poh Pei Fen, Dr Karen D. Nadua, ambulance driver Simon Lee, Dr Kelly Low and nurse manager Chandra Sekaran P.
Some members of KKH’s Chets team (from far left) assistant nurse clinician Poh Pei Fen, Dr Karen D. Nadua, ambulance driver Simon Lee, Dr Kelly Low and nurse manager Chandra Sekaran P. ST PHOTO: FELINE LIM
Baby Sih-Fa underwent many operations during his four-month stay in KKH.
Baby Sih-Fa underwent many operations during his four-month stay in KKH. PHOTO: COURTESY OF TAN ENG CHUN
Sih-Fa, now a healthy three-year-old, with his parents and older siblings on holiday in Egypt in March.
Sih-Fa, now a healthy three-year-old, with his parents and older siblings on holiday in Egypt in March. PHOTO: COURTESY OF TAN ENG CHUN

The joy of welcoming a newborn into the world turned into fear and worry for family physician Tan Eng Chun, 41, and his wife, Madam Teo Yin Yin, 40, in a matter of minutes.

Their son, Sih-Fa, had problems breathing within half an hour of his birth in 2014.

Doctors at the private hospital where he was delivered transferred him to the intensive care unit (ICU). But his condition continued to worsen the next morning.

That was when the private hospital contacted the Children's Hospital Emergency Transport Service (Chets) to take him to KK Women's and Children's Hospital (KKH).

A KKH Chets team arrived at the private hospital to set up a life- saving machine to take over the ailing baby's heart and lung func- tions during the trip. This machine is called the extra-corporeal membrane oxygenator (Ecmo).

Dr Tan said: "Chets was crucial to Sih-Fa's survival. His heart actually stopped the night he was transported to KKH. It was a huge relief that he was on Ecmo, as it prevented lasting damage to his brain."

KKH's Chets specialises in the safe transport of critically-ill children who need respiratory, cardiovascular or neurological support. This includes those with lung and other infections, congenital heart disease and other life-threatening conditions.

Since the service started in 2004, it has seen rising demand. The highest number of cases it had seen in a year was 100.

Chets came in for mention during the SG-ANZICS Intensive Care Forum 2017 held here last month. So far, the service has seen about 1,000 cases, based only on referrals from medical providers.

A team will first assess the feasibility of a transfer.

Once the patient is deemed suitable to be moved, the team will transport him to hospital within 30 minutes after being activated.

While most cases Chets sees are in Singapore, the team has gone to places as far as Copenhagen, Denmark, to render assistance.

Over the years, the service has been upgraded, such as by training staff for complex cases and getting more sophisticated medical equipment.

It started using a mobile Ecmo in 2011 to stabilise patients before taking them to KKH.

Unlike regular ambulance services, Chets functions as a mobile ICU with equipment to care for critically-ill children.

The service is staffed by neona- tologists, paediatricians trained in critical care and nursing staff from the KKH's neonatal intensive care unit and Children's Intensive Care Unit.

All new staff undergo a period of stringent assessment before becoming part of the Chets team. Team members also attend annual simulation-based training.

The service helps to increase the chances of survival for critically-ill children by transferring them safely and promptly to KKH for treatment.

This allows the children to undergo early therapy that is vital to stabilising their condition.

Sih-Fa underwent multiple operations during his four-month stay in KKH. He also developed a rare and severe lung disorder that led to his lungs being filled with fluid.

He has since recovered and is now a healthy three-year-old. His parents took him to Egypt for a holiday recently, together with his three siblings, aged four to 10 .

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A version of this article appeared in the print edition of The Straits Times on May 23, 2017, with the headline Mobile ICU unit that saves kids. Subscribe