C-NPT key terms

A rapid, hands-off first impression of a sick infant or child built from three sides: appearance, work of breathing, and circulation to the skin. It guides how urgently stabilization must begin before vital signs are even measured.

A sequential bedside examination-airway, breathing, circulation, disability, exposure-that finds and fixes immediately life-threatening problems first. During transport it is repeated after every move, procedure, or change in the patient's condition.

Completing essential interventions-airway control, vascular access, glucose, temperature, and drug therapy-at the referring hospital before departure, so the patient can tolerate the trip. Teams weigh this against the harm of delaying definitive care.

A 0–2 score for heart rate, respiratory effort, muscle tone, reflex irritability, and color, assigned at one and five minutes after birth. It summarizes response to resuscitation but does not by itself diagnose asphyxia.

Mean airway pressure multiplied by fraction of inspired oxygen, divided by arterial oxygen pressure, then multiplied by 100. Higher values mean worse gas exchange and help decide when to escalate to high-frequency ventilation or ECMO.

Positive pressure kept in the airways at the end of expiration that holds alveoli open, improves oxygenation, and prevents collapse. Excess PEEP can reduce venous return and blood pressure, so it is titrated against oxygenation and hemodynamics.

Ventilation using very small tidal volumes at a high rate around a constant distending pressure. Oxygenation depends mainly on mean airway pressure while carbon dioxide removal depends on amplitude and frequency; air trapping must be watched for.

The carbon dioxide measured at the end of exhaled breath, displayed as a waveform and a number. It confirms tracheal tube placement, estimates arterial carbon dioxide, and falls sharply with poor pulmonary blood flow or cardiac arrest.

Escape of gas from ruptured alveoli into pleural, mediastinal, or interstitial spaces, producing pneumothorax, pneumomediastinum, or pulmonary interstitial emphysema. Sudden desaturation with asymmetric breath sounds during positive-pressure ventilation calls for immediate needle decompression.

Instillation of exogenous surfactant into the trachea of premature infants with respiratory distress syndrome to lower surface tension, recruit alveoli, and improve compliance. It is given early; transient desaturation, bradycardia, and tube obstruction can occur during dosing.

Heart lesions in which either pulmonary or systemic blood flow depends on a patent ductus arteriosus. Closure of the ductus causes rapid deterioration, so these infants need prostaglandin and careful management of oxygen and ventilation.

A continuous infusion that keeps the ductus arteriosus open when ductal-dependent heart disease is suspected. Apnea, hypotension, and fever are common, so the airway and blood pressure must be watched closely throughout transport.

Early shock in which blood pressure is still normal because tachycardia and vasoconstriction compensate, while perfusion to skin, kidneys, and brain is already poor. Delayed capillary refill and cool extremities are clues before hypotension appears.

Pulse oximetry measured on the right hand and on a foot to compare saturation before and after the ductus arteriosus. A difference of more than a few percent suggests right-to-left shunting or persistent pulmonary hypertension.

A sudden worsening of cyanosis and distress in a child with tetralogy of Fallot, driven by increased right-to-left shunting. Treatment includes calming, knee-chest position, oxygen, fluid, and vasopressor or beta-blocker therapy.

An age-adjusted scale scoring eye opening, verbal response, and best motor response in infants and children. Serial scores track neurological deterioration and help decide about airway protection and destination.

Controlled cooling to roughly 33–34 °C, begun within six hours of birth, for moderate to severe hypoxic-ischemic encephalopathy. It reduces death and disability but demands precise temperature control and attention to bradycardia, clotting, and glucose.

Abnormal electrical brain activity in a newborn that may appear as subtle eye, mouth, or limb movements, apnea, or rhythmic cycling rather than classic convulsions. Confirmation often requires electroencephalography, and treatment addresses the underlying cause as well as the seizure.

A physical and neurological examination that estimates gestational age in newborns using features such as skin, ear cartilage, breast tissue, and posture. It helps teams anticipate respiratory distress, hypoglycemia, and feeding difficulty during transport.

Mean arterial pressure minus intracranial pressure. It is the driving pressure for blood flow to the brain, so hypotension or raised intracranial pressure in a head-injured child threatens cerebral oxygenation.

A method of estimating daily maintenance fluid from body weight: 100 mL/kg for the first 10 kg, 50 mL/kg for the next 10, and 20 mL/kg thereafter. It guides hourly rates and is adjusted for illness, losses, and glucose needs.

The milligrams of glucose delivered per kilogram per minute, calculated from dextrose concentration, infusion rate, and weight. It is used to titrate fluids for hypoglycemia or hyperglycemia in neonates, whose glycogen stores are limited.

An inflammatory bowel injury seen mostly in premature infants that causes feeding intolerance, abdominal distension, bloody stools, and lethargy. Transport care includes stopping feeds, decompressing the stomach, giving antibiotics and fluids, and watching for perforation and shock.

Placement of a nasogastric or orogastric tube to remove swallowed air and fluid, relieving distension that can splint the diaphragm and impair ventilation. It is routine in ventilated infants, bowel obstruction, and before air transport.

Calculating every medication dose from the patient's weight in kilograms, using a measured or recently documented weight. Because neonatal and pediatric weights vary widely, errors in weight, units, or decimal placement are common and dangerous.

A drug carrying a heightened risk of serious harm when used incorrectly, such as vasopressors, insulin, opioids, concentrated electrolytes, and anticoagulants. These require independent double checks, standardized concentrations, and clear labeling during transport.

Whether two medications or solutions can safely share one intravenous line through a Y-connector without precipitation or inactivation. Compatibility must be verified before drugs are infused together in a patient with limited vascular access.

How drug absorption, distribution, metabolism, and elimination differ in newborns, who have more body water, lower protein binding, and immature liver and kidney clearance. These differences change dosing intervals and raise the risk of toxicity.

The surrounding temperature range in which a baby uses the least oxygen and energy to keep a normal body temperature. Maintaining it prevents cold stress, hypoglycemia, and acidosis during assessment and transport.

Heat lost when water evaporates from wet skin or a wet surface, greatest in premature infants because their skin is thin and permeable. It is reduced by drying the infant, warming and humidifying gases, and covering the body.

A systemic bacterial infection in the first month of life, called early onset when acquired around birth and late onset when acquired afterward. Signs are subtle-temperature instability, poor feeding, apnea, shock-so antibiotics are often started empirically.

The fall in atmospheric pressure as altitude rises, which lets gas in trapped spaces, endotracheal cuffs, and air-filled equipment expand. Teams adjust cuff pressure, vent trapped air, and anticipate changes in oxygen delivery during air transport.

Estimated by dividing the cylinder's remaining gas volume in liters by the flow rate in liters per minute. Knowing this for each cylinder and each leg of the trip prevents running out of oxygen in flight or en route.

Approved seats or harness systems that hold the infant or child securely in an ambulance or aircraft, chosen for weight, age, and medical equipment. Unsecured children and equipment become projectiles in a crash or sudden maneuver.

A standardized review of airway equipment, medications, oxygen supply, battery charge, suction, and patient stability completed before leaving the referring site. It reduces omissions when teams are rushed or distracted.

Selecting and controlling a clear, obstacle-free area for helicopter takeoff and landing, marking hazards, keeping bystanders back, and securing loose objects. Ground crews must never approach the aircraft unless escorted by flight personnel.

A handoff format-situation, background, assessment, recommendation-used to transfer information between teams. It reduces omissions and misunderstandings when care passes from referring staff to transport crew or to the receiving unit.

Practice that treats parents as partners, explaining what is happening and involving them in decisions within the limits of an emergency. It reduces parental distress and supports the child's coping during transport.

A federal law requiring hospitals with emergency departments to screen and stabilize anyone with an emergency condition before transfer, and to transfer only when the benefit outweighs the risk and a receiving facility accepts.

Physician oversight of the transport team's protocols, scope of practice, and quality review, available for online consultation and offline guidance. It keeps decisions made en route within agreed standards and preserves accountability.