WHAT ARE NICU's

As the regular readers know, I am working with the Jackson Graves Foundation, http://www.jacksongraves.org/ , which works with Neonatal Intensive Care Units (NICU's) to help provide patients and families with resources that are not readily available.

I thought I would provide you with some information about NICU's so you can have a better understanding of the kids and families I am trying to help.

Learning all about the NICU is often the first step in preemie parenting. The first time you visit your baby in the neonatal intensive care unit (NICU) might feel like a visit to an alien planet. The sights, sounds, and smells are all unfamiliar, and the doors are locked and guarded. It may even seem like the people inside are speaking a different language! Knowing a little bit about intensive care nurseries and the caregivers you’ll meet there can make the experience less intimidating, allowing you to focus on your baby.

What is a NICU?


NICU (rhymes with pick you) stands for neonatal intensive care unit, sometimes called a special care nursery. These nurseries care for babies who are born early, who have problems during delivery, or who develop problems while still in the hospital.

Levels of NICU Care

Although all NICUs care for babies who need extra help, different NICUs offer different levels of care.

Level I: Basic Newborn Care: Level 1 nurseries care for healthy, full-term babies. They are able to stabilize babies born near term to get them ready to transfer to facilities that offer special care.

Level II: Specialty Newborn Care: These nurseries can care for babies born at greater than 32 weeks gestation or who are recovering from more serious conditions.

•Level IIA: These nurseries do not provide assisted ventilation.

•Level IIB: These nurseries can provide assisted ventilation for less than 24 hours, and can also provide continuous positive airway pressure (CPAP).

Level III: Subspecialty Newborn Care: Level III NICUs care for the sickest babies and offer the greatest variety of support.

•Level IIIA: These nurseries care for babies born greater than 28 weeks. They offer mechanical ventilation and minor surgical procedures such as central line placement.

•Level IIIB: Level IIIB NICUs can offer different types of mechanical ventilation, have access to a wide range of pediatric specialists, can use imaging capabilities beyond x-ray, and may provide some surgeries requiring anesthesia.

•Level IIIC: The most acute care is provided in level IIIC NICUs. These nurseries can provide advanced ventilation, including ECMO, and can provide advanced surgeries including “open-heart” surgeries to correct congenital heart defects.

NICU Staff and Caregivers

While your baby is in the NICU, he will be cared for by a team of doctors, nurses, and other medical professionals.

Neonatology: Neonatologists are pediatricians with additional training in the care of newborn babies. Neonatal nurse practitioners, or advanced practice nurses who specialize in care of newborns, and doctors in training to be pediatricians (residents) or neonatologists (fellows) may also help care for your baby under the supervision of an attending neonatologist.

Nursing: Nurses provide most of the day-to-day assessment and care of babies in the NICU. They work closely with parents and with neonatology to ensure the best care for the babies under their care.

Respiratory therapy: Respiratory therapists manage respiratory equipment, such as ventilators and CPAP machines to make sure they are functioning according to doctors’ orders. They may also provide breathing treatments.

Occupational and physical therapists: Premature babies require special positioning to promote healthy growth and development, may need special help to make sure they are learning to eat well, and may benefit from infant massage. Occupational therapists (OTs) and physical therapists (PTs) provide these services.

Ancillary staff: In addition to the health care workers listed above, many other helping hands may also care for your family while your baby is in the NICU. You may meet pharmacists who prepare medications for babies in the NICU, lactation consultants to help moms provide breast milk for their babies and help moms learn to breastfeed their premature infants, and chaplains and counselors to help parents cope with their baby’s illness.

Sources:

American Academy of Pediatrics. “Levels of Neonatal Care” Pediatrics 2004 114:1341-1347.

Children’s Hospital of Pittsburgh. “Procedures and Equipment in NICU.” Accessed November 22, 2008. http://www.chp.edu/CHP/P02358

Children’s Hospital West. “Our Caring NICU Staff.” 2008. Accessed November 22, 2008. http://www.memorialwest.com/neonatal/staff.aspx

March of Dimes. “Glossary: Common NICU Equipment.” October 2008. Accessed November 22, 2008. http://www.marchofdimes.com/prematurity/21278_11032.asp

Nemours Foundation. “When Your Baby’s In the NICU.” Accessed November 22, 2008. http://kidshealth.org/parent/system/ill/nicu_caring.html