Women and Newborn Health Service
Services A — Z
King Edward Memorial Hospital
Neonatology Clinical Care Unit
List of Updated NCCU Guidelines
- About us
- Disclaimer/Aims
- Standards for all cares and procedures
- Admission Policy
- Visiting guidelines
- Admission Guidelines for PMH/Ward 6B Neonatal Unit
- Readmission of Infants
- Aseptic Technique in NICU
- Codes
- Competencies
- Consultation in the NCCU KEMH
Drug Protocols
PREM Bank
Section 1: Resuscitation and Admission to NICU
Section 2: Respiratory Problems and Management
Section 3: Pain Assessment and Management
Section 5: Venous and Arterial Access, Sampling and Line Management
Section 6: Nutrition - Enteral and Parenteral
Section 8: Infection, Septic Screening and Management of Infection
Section 10: Metabolic Management
Section 11: Newborn Emergency Transport Service (NETS)
Section 12: Imaging Procedures
Section 13: Surgical Conditions
Section 14: Cardiac Conditions
Section 16: Elimination and Fluid Balance
Section 17: Neonatal Abstinence Syndrome
Section 18: Family and Developmental Care
Section 19: Transfer from NICU and Discharge Planning
Section 20: Palliative Care and Death of a Neonate
Section 21: Care of the Postnatal Mother on Ward 6B
Section 1 - Resuscitation and Admission to NICU
- Preventing Heat Loss At Delivery For All Gestations
- Neonatal Resuscitation
- NRP Algorithm
- Who Attends Deliveries (KEMH)
- The Neopuff
- Air or Oxygen
- Administration of Drugs and Fluids
- Post Resuscitation Care
- When to Cease Resuscitation Attempts / Special Circumstances
- Identification of Infants
- Admission for 'Newborn Care' Level 1 care
- Infants of Women in ASCU (KEMH)
- Admission: Level 2 Care
- Admission: Level 3 Care
- Weight, Length and Head Circumference Measurements
- Ordering Blood Tests
- Monitoring and Observation Frequency Guidelines
- Blood Pressure in the Neonate
- References
Section 2 - Respiratory Problems and Management
- Respiratory Problems
- End tidal CO2 monitoring
- Apnoea of Prematurity
- Major Anomalies
- Respiratory Procedures
- Emergency procedures
- Modes of Ventilation
- References
Section 3 - Pain Assessment and Management
- Pain Assessment
- Pain Management
- Recommended Guidelines for Treatment of Iatrogenically acquired Neonatal Narcotic Dependence
- Oral Sucrose for Procedural pain relief
- Appendix 1: PIPP pain assessment tool
- Appendix 2: Pain Assessment and Intervention Chart 1 & Chart 2
- Appendix 3: PAT Tool
- Appendix 4: PAT assessment and intervention chart
- References
Section 4 - Thermoregulation
- Admission of infants onto radiant warmer greater than 30weeks gestation or 1500gms birth weight
- Admission of infants onto radiant warmer less than 30weeks gestation or 1500gms birth weight
- Humidity
- Incubators
- Infants less than 30 weeks or less than 1500gms
- Modes of heat loss
- Neonatal temperature ranges
- Thermal control of very preterm infants after delivery
- Transition from an incubator to an open cot (grading out of an incubator)
- Heated mattress and cosy therm
- References
Section 5 - Venous and Arterial Access, Sampling and Line Management
- Intravenous Catheter Insertion
- Extravasation injuries
- Central Venous Catheters
- Removal of Central Venous Catheter
- Changing TPN Giving Sets Via Central Lines (PICC Line, Longline, CVC)
- Administration of Medication through CVC / Longline Catheter
- Dressing Changes for Central Venous Catheters / Longlines
- Umbilical Catheters
- Removal of UAC or UVC
- Insertion of a Peripheral Arterial Catheter
- Sampling
- Insertion and care of Intraosseous needle
- References
Section 6 - Nutrition: Enteral And Parenteral
- Volume and nutritional requirements
- Total Parenteral Nutrition
- Enteral Feeding - Initiation and Progression and Mineral and Vitamin Supplementation
- Perron Rotary Express Milk Bank
- Options for Milk Feeding for Newborn Infants at KEMH or PMH
- Milk Fortification and Infant Formula
- Gastric tube placement and testing
- Nasogastric tube testing Flowchart
- Feed intolerance
- Interrmittant (Bolus) Feeds
- Continuous milk feeds
- Rescheduling of feeds
- Tube feeding by parents in the NICU
- Bottle feeding
- Gastro-oesophageal reflux
- Pierre Robin Sequence
- References
Section 7 - Breastfeeding
- Health Benefits
- Breastfeeding the Term infant
- Breastfeeding the Preterm infant
- Positioning and attachment at the breast
- Nutritive and non-nutritive sucking
- IGT top-ups following breastfeeds
- Increasing the number of breastfeeds
- Giving a Bottle feed (EBM or BMS) to the breastfeeding infant
- Use of Nipple Shields for Preterm Infants
- Breastfeeding challenges
- Preparation for discharge home
- Handling, Storage and Transport of Expressed Breast milk
- Labelling and checking of expressed breast milk
- Collection of breast milk from Milk Kitchen
- Ingestion of Expressed Breast milk by Incorrect Donor
- Further reading
Section 8 - Infection, Septic Screening and Management of Infection
Section 9 - Haematology
- Anaemia and Bleeding disorders
- Administering blood and blood products
- Directed donation
- Thromboembolic Disorders
- Polycythaemia and hyperviscosity
- Exchange transfusion
- References
Section 10 - Metabolic Management
- Newborn Screening Test (NBST)
- Inherited Metabolic Disorders
- Neonatal Hyperammonaemia Guidelines
- Metabolic Bone Disease
- Hypoglycaemia
- Jaundice
- Phototherapy
- Exchange transfusion
- Immunoglobulin Infusion
- Appendix
- References
Section 11- Newborn Emergency Transport Service (NETS)
Section 12 - Imaging Procedures
Section 13 - Surgical Conditions
- General Pre Operative Care
- General Post Operative Care
- Malrotation/Volvulus of the Intestines in Neonates
- Tracheostomy
- Care of Infant Post Cardiac Catheterisation
- Oesophageal Atresia / Tracheoesophageal Fistula
- Pyloromyotomy
- Gastroschisis
- Exomphalus (omphalocele)
- Bowel Washout
- Necrotising Enterocolitis
- Transfer of preterm infants with NEC to the NICU at PMH
- Care of the Infant with Meningocele / Myelomeningocele
- Insertion or Revision of Ventriculoperitoneal Shunt
- Cleft Lip and/or Palate
- Non-Strangulated (Non-obstructed) Inguinal Hernia
- Pre and post operative care of repair of inguinal hernia
- Retinopathy of Prematurity (ROP) - Pre and Post Operative Management of Laser Treatment
- Choanal Atresia
- References
Section 14 - Neonatal Cardiac Conditions: Medical and Surgical Management
- The Circulation:
- Neonatal circulation (pending)
- Unbalanced circulation (pending)
- Methods to influence the circulation (pending)
- Congenital Heart Disease:
- CHD overview
- Syndromes associated with congenital cardiac defects (pending)
- Pulse oximetry screening on postnatal wards to detect critical congenital heart disease (pending)
- Individual Lesions / Conditions – General Information and Management
- Congenital structural defects and anomalies (pending)
- Aortic valvular stenosis – critical (pending)
- ALCAPA (Anomalous Left Coronary Artery arising from Pulmonary Artery) (pending)
- Atrioventricular Septal Defect (AVSD)/ AV Canal Defect (pending)
- Coarctation of Aorta (CoA)/ Interrupted Aortic Arch (IAA) (pending)
- Ebstein's anomaly (pending)
- Hypoplastic Left Heart Syndrome (HLHS) (pending)
- Patent Ductus Arteriosus (PDA)
- Pulmonary Atresia +/- VSD/ Severe Pulmonary Stenosis (pending)
- Tetralogy of Fallot – Severe (pending)
- Total Anomalous Pulmonary Venous Return (TAPVR) (pending)
- Transposition Great Arteries (TGA) (pending)
- Tricuspid Atresia (pending)
- Truncus Arteriosus (pending)
- Single Ventricle Anomalies/ Double Outlet Right/ Inlet Left Ventricle (DORV/ DILV) (pending)
- Vascular Rings (pending)
- Ventricular Septal Defects (VSD)/ Multiple (VSDs) (pending)
- Cardiomyopathy (pending)
- Cardiac Arrhythmias
- Congenital structural defects and anomalies (pending)
- General Surgical Management of the Cardiac Patient
- Preparing a cardiac patient for theatre (pending)
- Receiving a cardiac patient from theatre
- Routine care post cardiac surgery
- General complications following cardiac surgery
- Receiving a cardiac patient from PICU (pending)
- Cardiac Procedures – Medical and Surgical
- BT shunt
- Coarctation of the aorta repair
- PDA repair
- Other Cardiac Surgical procedures (pending)
- Atrial septostomy (pending)
- Defibrillation (pending)
- Drugs used in Cardiac Patients (pending)
- Use of Lactate Measurement (See General complications following cardiac surgery in General Surgical Management) (pending)
- Transfer of Cardiac Patient to another Centre (pending)
- Appendices
- Normal Blood Pressure Value Graphs (pending)
- Abbreviations used in Cardiology (pending)
Section 15 - Neurology
- Systemic Cooling For Neuroprotection In Neonates ≥ 35 Weeks Gestational Age With Hypoxic Ischaemic Encephalopathy (HIE)
- Cranial Ultrasound
- Hypoxic Ischemic Encephalopathy
- Neonatal Seizures
- Brainz monitor low impedance needle electrodes
- Ventricular Tap
- References
Section 16 - Elimination and Fluid Balance
Section 17 - Neonatal Abstinence Syndrome
- Neonatal Abstinence Syndrome intro
- Diagnosis of NAS
- Postnatal care
- Pharmacological Treatment
- Non-opiate CNS depressant withdrawal
- Assessment and care if the infant with NAS
- Discharge planning
- NAS home management program
- Information for parents re: management of NAS
- Appendix A - NAS Scoring system Guideline
- Appendix B - Assessment of the infant with NAS, using the NAS chart
- References
Section 18 - Family & Developmental Care
- Parenting
- Skin to skin
- Positioning
- Parent accomodation
- Complex longterm care
- Noise Reduction
- References
Section 19 - Transfer & Discharge
- Discharge Planning/Information
- Discharge Guidelines for Babies Taken into Care by Department of Child Protection Office
- Discharge Against Medical Advice
- Discharge Home on Oxygen
- Retinopathy Of Prematurity (Rop)
- Immunisations
- DDH
- Hip referral form NICU PMH (Ward 6B)
- Hip referral form NICU KEMH (SCN)
- Relinquishment For Adoption
- Transfer & Transportation Of Infants
- References
Section 20 - Palliative Care and Death of a Neonate
- Palliative care
- Baptism
- Post mortem examination and Coronal Notification
- Dealing with Grief
- Last Offices and documentation
- Funeral Arrangements
- Viewing the Infant
- Further reading
Section 21 - Care of the Postnatal Mother on Ward 6B
- Postnatal midwifery care
- A guide for prescribing and giving medications to mothers of 6B infants
- Ward 6B Maternal Secondary Post Partum Haemorrhage (PPH) Guideline
