Derived from the National Pediatric Cardiology Quality Improvement Collaborative registry, the NEONATE risk score predicted freedom from interstage mortality or heart transplant for patients with single ventricle CHD and aortic arch hypoplasia discharged home following Stage 1 palliation.

We sought to validate the score in an external, modern cohort.

This was a retrospective cohort analysis of single ventricle CHD and aortic arch hypoplasia patients enrolled in the National Pediatric Cardiology Quality Improvement Collaborative Phase II registry from 2016 to 2020, who were discharged home after Stage 1 palliation. Points were allocated per the NEONATE score (Norwood type—Norwood/Blalock–Taussig shunt: 3, Hybrid: 12; extracorporeal membrane oxygenation post-op: 9, Opiates at discharge: 6, No Digoxin at discharge: 9, Arch Obstruction on discharge echo: 9, Tricuspid regurgitation ≥ moderate on discharge echo: 12; Extra oxygen plus ≥ moderate tricuspid regurgitation: 28). The composite primary endpoint was interstage mortality or heart transplant.

In total, 1026 patients met inclusion criteria; 61 (6%) met the primary outcome. Interstage mortality occurred in 44 (4.3%) patients at a median of 129 (IQR 62,195) days, and 17 (1.7%) were referred for heart transplant at a 167 (114,199) days of life. The median NEONATE score was 0(0,9) in those who survived to Stage 2 palliation compared to 9(0,15) in those who experienced interstage mortality or heart transplant (p < 0.001). Applying a NEONATE score cut-off of 17 points that separated patients into low- and high-risk groups in the learning cohort provided 91% specificity, negative predictive value of 95%, and overall accuracy of 87% (85.4–89.5%).

In a modern cohort of patients with single ventricle CHD and aortic arch hypoplasia, the NEONATE score remains useful at discharge post-Stage 1 palliation to predict freedom from interstage mortality or heart transplant.

Early during COVID-19, British Columbia coordinated collaboration between academic researchers, public healthcare systems, and private sector partners to focus research resources on knowledge gaps in a timely manner, avoid duplication, and identify overlooked aspects. At a collaboration symposium, it became evident that BC’s volunteer search & rescue (SAR) cadre was overlooked.

Our exploratory project studied volunteer SAR’s operational readiness; use and perceived value of information sources; consistency in infection prevention measures among volunteer stations, and with their professional counterparts for comparable first aid medical interventions throughout the pandemic.

We partnered with the 2 organizations that govern BC’s volunteer SAR stations. Local station leaders completed a short confidential survey. Guidance documents issued by associations governing voluntary and professional first responders were compared.

Survey responses were received from 33 of 109 local stations, spanning all regions of BC. Most remained operationally ready throughout the entire pandemic (12.1% had to stand down at times). Except for 21% lacking eye protection, all had personal protective equipment commensurate with that of healthcare professionals; however, few used this PPE in a manner consistent with professional counterparts. Usage and perceived usefulness of various information sources differed. There was no communication link between the province’s infection control experts and 2 volunteer SAR organizations.

Search & rescue capability was maintained despite pandemic impacts. Results reveal strengths and opportunities for improvement in the ways volunteers are informed and protected. Infection control experts providing advice for emergency health services professional responders should remember to include their volunteer counterparts.