The Southern Alberta Neonatal Transport Service (SANTS) is a team of specially trained healthcare professionals (Registered Nurses and Registered Respiratory Therapists) that assists in the stabilization and transport of newborns needing a higher level of care than their local health center can provide. These babies are transported to Neonatal Intensive Care Units or other pediatric facilities where they can receive the lifesaving care they need.

The SANTS team is based out of the Foothills Medical Centre NICU in Calgary, Alberta and provides service to the Calgary, Central and Southern Zones within Alberta Health Services, as well as other provinces when needed. The team can also assist with the insertion of neonatal PICC lines if this service is not available locally. 

When not on transport, the SANTS team acts as a clinical resource to the FMC NICU providing multidisciplinary education, attending codes, and assisting or performing advanced skills (intubation, UVC/UAC insertion, PICC line insertion). Outreach Education is another important aspect of SANTS, providing the necessary teaching and skills to referral sites for the stabilization and care of sick neonates while awaiting the team.

RAAPID serves as the contact point for the referral site, SANTS team and the Transport Neonatologist. This conference call is recorded and serves as a "telephone consultation" between the referral site and SANTS team/Transport Neonatologist.



The Steps to Transport

There are many reasons a baby might require transport, but the most common conditions requiring transport are: presentation to a non-delivering (Level 0) healthcare facility, prematurity (<35 weeks gestation), hypoglycemia, respiratory distress, Hypoxic Ischemic Encephalopathy (HIE), and possible sepsis.

  • Referral site identifies an at-risk or sick neonate and initiates a RAAPID call. The SANTS team and Transport Neonatologist are paged with the RAAPID phone number and PIN to join the call.

  • The SANTS team asks the 4 questions: How old is the baby from birth (hours/days)? What is the gestational age of the baby? What FiO2 is the baby on, and what is the current oxygen saturation? What is the main concern requiring transport?

  • If the baby requires transport, the SANTS team will be mobilized by the Transport Neonatologist and prepare for departure.

  • The Transport Neonatologists and/or NICU Fellows can give advice on how to proceed with treatment/stabilization by phone or Telehealth.

  • The SANTS team arrives at the referral site, provides care as ordered by MRHP and/or Transport Neonatologist to stabilize the patient.

  • The SANTS team will do a "call-back" to the Transport Neo and receiving Neonatologist/Pediatrician, providing a thorough history, report and will receive transport orders.

  • SANTS team transports patient to receiving site and gives handover to receiving medical and bedside staff.

Mobilizing the Team

Process, Documents and Resources for Receiving and Triaging RAAPID Calls

NICU Transport Calls

  1. RAAPID page received, all members call in using phone # and PIN provided. The patient's ULI may also be provided in the page for searching NetCare or Connect Care. The first person on the call should ensure that all of the following staff have been paged to the call:
    • Transport Neonatologist
    • ACH NICU Fellow
    • ACH NICU Clinician/Charge Nurse
    • SANTS team at FMC
    • FMC NICU Clinician/Charge Nurse
    • Refer to SANTS RAAPID Paging Workflows
  2. When connected with the referral site, ask the 4 Questions. This can be done by any staff (although usually by the SANTS team) and should be done ASAP. If the Transport Neonatologist and/or SANTS team are not on-line for the 4 questions, please provide this information when they join the call. 
    1. How old is the baby from birth?
    2. What is the gestational age of the baby?
    3. Is the baby on respiratory support? If yes, what type, what is the FiO2 and SpO2 saturation?
    4. Briefly, what is your main concern presenting for transport or advice?
  3. SANTS team is mobilized by the Transport Neonatologist and they will begin booking the mode of transportation, prepping equipment etc.
  4. Continue to triage the call and add other centres as needed based on the SANTS RAAPID Transport Workflows. Referrals are classified as:
    • Emergent: Mobilization <15 minutes (transport by STARS may be advisable)
      • Delivery at a Level 0 (non-delivering) site
      • <32 week delivery at Level 1 site
      • <28 week delivery at Level 2 site
      • Infant being resuscitated
      • Difficulty with stabilization
    • Urgent: Mobilization <30 minutes
      • Most other transport calls
    • Elective: Mobilzation <60 minutes or at a mutually agreeable time to the sending and receiving sites
  5. Transport Neonatologist/Fellow will remain on the line to provide guidance/orders/help direct care as needed. 


Telehealth Information

Telehealth is the telemedicine platform used by AHS to provide two-way video calling between referral sites and SANTS. Telehealth is now hosted by the Zoom platform so that users can join the call from any location. Virtually all rural sites have the capacity for Telehealth, and this can be a helpful tool in assessing patients, guiding the referral team through a procedure, or providing support while the SANTS team is enroute.

Please refer to the SANTS - Zoom Consultation Guideline for more information, and use the QR Codes below to join a meeting

NICU Transport Calls- Out of Province

Occasionally, the SANTS team will be consulted for Out of Province (OOP) transports. The OOP Transport Pathway is very similar to the regular Pathway with some important distinctions:

  • Before asking the 4 Questions, please ask "did the call go through BCEHS Patient Transport Network?" This avoids logistical delays. Their phone number is 1-866-223-2337, please ask RAAPID to add them to the call.
  • If the call meets Urgent or Elective mobilization criteria, please contact the Executive Director on Call (on a separate call) to obtain approval for the transport. This is not required for Emergent calls. Authorization will be obtained at a later time, patient care is the priority.


NICU vs PICU Transport Calls

RAAPID referrals involving neonates may be attended to by NICU or PICU transport teams based on several factors including:

  • Age of the infant. Generally, <44 weeks will be transported by NICU and >44 weeks will be transported by PICU. Infants >5 kg should be transported by PICU.
  • Presentation of the infant. If the infant has been discharged after birth, or spent time in the community, they will generally be transported by PICU as Calgary Zone NICU's (aside from ACH) do not accept patients that have been previously discharged home.
  • Candidacy for ECLS (Extra Corporeal Life Support). These patients are transported by PICU.
  • Team resources. If either NICU or PICU's resources are exhausted, the other team may be mobilized to support for appropriate patients, as determined by the Transport Physician and team members.
  • Please refer to the SANTS RAAPID NICU or PICU Algorithm.pdf


Calling in a Second High Risk Team

There are times when the demand for SANTS team members will be greater than the current staffing (multiple calls, acuity of referrals, etc), and additional staff must be called in. Please refer to the Calling in a Second High Risk Transport Teamresource document.

Our Catchment Area

SANTS provides service to the Central, Calgary and South Zones of Alberta Health Services.


 To see transport times, and delivery/NICU status (Level 0/1/2/3) of specific sites, please refer to the Chart of Call


Referral Site Information

This section includes resources to provide background information on what supplies, resources and personnel are available at a Level 0/1/2/3 referral site

Level 0 (Non-Delivering) Sites

  • Are not intended to care for ante/peri/postpartum patients and neonates
  • Do not have an Operating Room on-site (no anesthetist, may or may not have ready access to blood products
  • May have limited (or no) neonatal resuscitation equipment/supplies
  • Will not have ready access to blended FiO2 
  • May not have NRP trained staff, or access to current NRP Algorithms
  • May only have one physician on-site
  • May not have x-ray, lab or other services available 24/7 or at all.
  • Many sites have Telehealth (but not all)
  • Need to create a "Level 0 questions and advice document"

To help guide the referral site in their preparation, equipment setup, and personnel, please refer to Level 0 Supplies and Setup Guide


Level 1 Sites

  • Cares for low-risk intra and postpartum patients and neonates
  • Have an Operating Room on-site (access to anesthetist, and at least 2 units O-negative PRBC's)
  • Will have Panda warmer/resuscitator and resuscitation supplies per NRP
  • May have some supplies for extremely premature infants. Refer to Level 1 Golden Hour Checklist
  • Will have access to blended FiO2 via Panda warmer
  • NRP trained RNs and Physicians (No RRT's)
  • 2+ physicians on-site
  • X-ray/lab etc may need to be paged from home, but are available
  • Most sites have Telehealth


Level 2 Sites- Outside Calgary Zone

  • Cares for ante/peri and postpartum patients and neonates 
  • NICU care for >32 weeks' gestation (CPAP, HFNP, UVC's, PIV's, PICC's)
  • Care is managed by a pediatrician 
  • RRT coverage (shared w/ hospital)
  • 24/7 lab/x-ray
  • Have supplies for extremely premature infants
  • All have Telehealth


Level 2 Sites- Calgary Zone

  • Medical team is led by a Neonatologist or Pediatrician. Neonatal Nurse Practitioners and Clinical Assistants may also be on the medical team and provide night coverage
  • Dedicated RRT coverage
  • NICU care for >32 weeks' gestation (CPAP, HFNP, UVC's, PIV's, PICC's)
  • Care is managed by a pediatrician 
  • RRT coverage (shared w/ hospital)
  • 24/7 lab/x-ray
  • Have supplies for extremely premature infants
  • Telehealth unavailable

Modes of Transportation

The mode of transportation is determined by the patient's condition, the distance to the referral site, and available resources. Each call is triaged by RAAPID and the SANTS team to determine the most appropriate transport vehicle. SANTS has three modes of transportation:


Ground Ambulance

After mobilization, EMS crews are dispatched to assist SANTS in reaching both local and rural sites. EMS also transports our team and equipment between the hospital and airport when travelling by fixed wing. This is the most common mode of transport for SANTS missions, and EMS plays a key role in virtually all of our trips.

Fixed Wing Air Ambulance

Fixed wing is the mode of choice when the team has to travel a greater distance, and there is an airport near the referring center. Fixed wing transport results in shorter out-of-hospital times for the patient, but may have similar arrival times compared to ground transport as the team has to travel between the hospital(s) and airport(s). Flights are arranged by phone through the Central Communication Centre (CCC) 116-9187-91-780-407-4043.

STARS Air Ambulance

In emergent circumstances, STARS may be the fastest way to get to a baby in need of lifesaving care, no matter the referral site. STARS aircrafts can only transport the team and its mobile equipment- not the isolette or the patient. In this case, an ambulance must still be dispatched to transport the isolette to the referral site, and then transport the team and patient to the receiving site. Of note, STARS aircrafts must be reconfigured for SANTS transports, so there is a "download" time required prior to picking up the team.

Other Learning Courses

These modules and websites have been created just for the SANTS team

SANTS Leadership