Dear Gian,

As with many instances with babies there are few pieces of equipment that are carried on ambulances to fit such unique and rare circumstances, that is if it is a regular ambulance and not a specified neonatal transfer unit. However I have found in my experience that using the vacuum mattress equipment commonly used for splinting adult long bone fractures, you are able to immobilise the baby without causing further injury. Due to the size of this equipment with a baby

Thanks Laini for your reply. I need to know what is used in other countries and other professionals. Also we use this useful and convenient system.

I would wrap them nice and snug in their car seat. A towel or rolled up piece of news paper can serve as a temporary collar if required. Keep the warm and hopefully they will sleep and so there will be minimal movement and maintain spinal immobilisation.

Thanks for your reply Richard. I have a question; if the car and the seat with the child have had an accident, how can you be sure that the seat is intact? Who does it ensure that the seat can travel safely on board the ambulance? The seat may be deformed! Ambulance insurance may not provide insurance coverage in case of secondary damage to the baby and so even the manufacturer of the car seat.

Within some ambualance services in Australia we utilise either in-vehicle child restraint seats with manufacturer approved webbing straps and designated attachment points within vehicle (Primarily Mercedes ambulances) or a device called a Pedi-mate which is a harness system that attaches to a forward facing seat.  With a child which requires full spinal care - outside of vacuum mattresses there is very little on the market and it is a constant source of concern for us who work within the pre-hospital care world.

Under conditions which allow it, I usually nominate to go with the child in the parents car as this is a safe alterative for transport - obviously with the inherent complications that this brings.