 |
Neonatal and Perinatal Medicine Rotations in the NICU consist of one-month block experiences. Residents identify patients requiring admission to the NICU. The spectrum of patients seen fills the gamut of neonatal disease including extreme prematurity, congenital malformations, congenital heart disease, RDS, sepsis, anemia, hyperbilirubinemia, birth trauma, fluid and electrolyte disorders, inborn metabolic errors, congenital infections, asphyxia, etc. Residents in the NICU admit, evaluate and frequently re-assess patients, devise a management plan, document progress, obtain and evaluate lab tests, perform invasive procedures (intubation, umbilical line placement, arterial line placement, thoracostomy and chest tube placement), manage ventilators, assess invasive monitoring results (ICP, CVP,IBP), order therapy and make therapeutic changes, communicate with parents and with the team of care providers. Supervision is provided by board certified neonatologists who are present in-house 24 hours per day, 7 days per week. At the beginning of residency, all residents are trained in and expected to be certified in Neonatal Advanced Life Support. Each month at the start of each rotation, resuscitation protocols and techniques are reviewed using a video presentation, mock codes, discussion and skill demonstration. Resuscitation mannequins are available for practice. Senior residents lead PL1 junior residents and physician extenders in resuscitations in the NICU, delivery room and operating room. Residents respond to calls from the delivery room for all high risk or complicated deliveries. Instruction is provided during the course of the rotation and again as needed in neonatal transport both between institutions and within the institution. Residents are included in the transport team. Staff neonatologists also supervise neonatal transports. The NICU at KCHC is a brand new ultra modern 30 bed tertiary care unit. The unit has an open floor plan and each bed is monitored at a central station. This NICU provides high frequency ventilation, microprocessor controlled conventional ventilation, nitric oxide administration, hypothermia therapy along with 24/7 availability of anesthesia and radiology services including CT and MRI. There is a portable C-arm kept on the unit. In addition, there is a treatment/procedure room, several single patient isolation rooms, consultation room, conference rooms and a family bereavement room. All pediatric subspecialties and pediatric surgical specialty services are readily available. The NICU at UHB is a 25 bed tertiary care unit capable of advanced and sophisticated neonatal care. Respiratory services are provided by NICU dedicated pediatric respiratory therapists and include inhaled nitric oxide and high frequency ventilation. There is also 24/7 availability of radiology services and various subspecialties. Micromethod laboratory processing, NICU I-Stat labs and blood gases are available. The nurses have extended roles. Physician extenders including nurse clinicians and physician assistants are integral members of the patient care team. There are dedicated social work support and nutrition services. This unit supports a fully staffed and fully equipped transport team. This NICU was recently designated by the NYS Health Dept. as a Regional Perinatal Center. Current areas of research within the Division include studies on regional blood flow, treatment with hypothermia, indirect calorimetry and energy expenditure, colorimetry and gestational age assessment, antioxidants and nutrition.
|
||||||||
|
|
|||||||||
