Newborn Common Scenarios/Special Situations - Revision history

JenniferH: /* Preterm and Sick Infants */

2022-02-10T06:35:02Z

Preterm and Sick Infants

← Older revision		Revision as of 06:35, 10 February 2022
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	*[[media:Neonatal resuscitation summary.pdf\|Neonatal Resuscitation Summary Chart]] (pdf)		*[[media:Neonatal resuscitation summary.pdf\|Neonatal Resuscitation Summary Chart]] (pdf)
	*[[Premie_Warm_Welcome_Protocol\|YKHC Premie Warm Welcome Protocol]]		*[[Premie_Warm_Welcome_Protocol\|YKHC Premie Warm Welcome Protocol]]
			*[[media:Late_preterm.pdf\|Care of Late Preterm Newborns YKHC Clinical Guideline]]


	[[:Category:OB & Newborn\|OB & Newborn Main Page]]		[[:Category:OB & Newborn\|OB & Newborn Main Page]]

JenniferH: /* Circumcision */

2022-02-10T06:25:03Z

Circumcision

← Older revision		Revision as of 06:25, 10 February 2022
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	This procedure is done most commonly prior to discharge, but also can be done outpatient for up to 4 weeks. A detailed consent form must be signed by the mother. Generally, only privileged active medical staff are able to do circumcisions due to the paucity of procedures.		This procedure is done most commonly prior to discharge, but also can be done outpatient for up to 4 weeks. A detailed consent form must be signed by the mother. Generally, only privileged active medical staff are able to do circumcisions due to the paucity of procedures.

			==Head Ultrasound==
			Requests for head ultrasound are rare, but have occurred. Any infant needing a head ultrasound will need to travel to Anchorage for evaluation as we do not have the correct equipment (no head ultrasound transducer) nor expertise to complete them adequately.

	==Neonatal Drug Exposure==		==Neonatal Drug Exposure==

JenniferH: /* Neonatal Drug Exposure */

2020-11-21T08:53:46Z

Neonatal Drug Exposure

← Older revision		Revision as of 08:53, 21 November 2020
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	==Neonatal Drug Exposure==		==Neonatal Drug Exposure==
	If the pregnant woman is known to use narcotic medication that could put the infant at risk of neonatal abstinence syndrome, all reasonable attempts to have the mother travel to Anchorage for her 'be-in-Bethel (BIB)' date. If the infant is delivered in Bethel, we now follow the '''Eat, Sleep, Console Approach''' ~~to manager any symptoms that develop.~~ <ref>Grisham et al. [https://journals.lww.com/advancesinneonatalcare/Abstract/2019/04000/Eat,_Sleep,_Console_Approach__A_Family_Centered.11.aspx Eat, Sleep, Console Approach: A Family-Centered Model for the Treatment of Neonatal Abstinence Syndrome]. Advances in Neonatal Care: April 2019 - Volume 19 - Issue 2 - p 138-144. doi: 10.1097/ANC.0000000000000581.</ref>		If the pregnant woman is known to use narcotic medication that could put the infant at risk of neonatal abstinence syndrome, all reasonable attempts to have the mother travel to Anchorage for her 'be-in-Bethel (BIB)' date are made. If the infant is delivered in Bethel, we now follow the '''Eat, Sleep, Console Approach'''<ref>Grisham et al. [https://journals.lww.com/advancesinneonatalcare/Abstract/2019/04000/Eat,_Sleep,_Console_Approach__A_Family_Centered.11.aspx Eat, Sleep, Console Approach: A Family-Centered Model for the Treatment of Neonatal Abstinence Syndrome]. Advances in Neonatal Care: April 2019 - Volume 19 - Issue 2 - p 138-144. doi: 10.1097/ANC.0000000000000581.</ref> to manager any symptoms that develop.
	===References===		===References===
	<references />		<references />

JenniferH: /* Neonatal Drug Exposure */

2020-11-21T08:52:53Z

Neonatal Drug Exposure

← Older revision		Revision as of 08:52, 21 November 2020
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	==Neonatal Drug Exposure==		==Neonatal Drug Exposure==
			If the pregnant woman is known to use narcotic medication that could put the infant at risk of neonatal abstinence syndrome, all reasonable attempts to have the mother travel to Anchorage for her 'be-in-Bethel (BIB)' date. If the infant is delivered in Bethel, we now follow the '''Eat, Sleep, Console Approach''' to manager any symptoms that develop. <ref>Grisham et al. [https://journals.lww.com/advancesinneonatalcare/Abstract/2019/04000/Eat,_Sleep,_Console_Approach__A_Family_Centered.11.aspx Eat, Sleep, Console Approach: A Family-Centered Model for the Treatment of Neonatal Abstinence Syndrome]. Advances in Neonatal Care: April 2019 - Volume 19 - Issue 2 - p 138-144. doi: 10.1097/ANC.0000000000000581.</ref>
			===References===
			<references />

	==Preterm and Sick Infants==		==Preterm and Sick Infants==

JenniferH: /* Circumcision */

2020-11-21T08:42:37Z

Circumcision

← Older revision		Revision as of 08:42, 21 November 2020
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	This procedure is done most commonly prior to discharge, but also can be done outpatient for up to 4 weeks. A detailed consent form must be signed by the mother. Generally, only privileged active medical staff are able to do circumcisions due to the paucity of procedures.		This procedure is done most commonly prior to discharge, but also can be done outpatient for up to 4 weeks. A detailed consent form must be signed by the mother. Generally, only privileged active medical staff are able to do circumcisions due to the paucity of procedures.

			==Neonatal Drug Exposure==

	==Preterm and Sick Infants==		==Preterm and Sick Infants==

JenniferH: /* Preterm and Sick Infants */

2020-11-21T08:27:57Z

Preterm and Sick Infants

← Older revision		Revision as of 08:27, 21 November 2020
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	Remember the ER and NW have nurses and staff that can help as well.		Remember the ER and NW have nurses and staff that can help as well.

	Many, apparently well seeming, infants delivered less than 36 weeks end up needing to be transferred because of difficulty with feeding and ~~thermoregulations~~. Closely monitor these infants and have a low threshold to send these babies to Anchorage. Babies that deliver 36-37 weeks often do well, but these also need to be monitored and transferred if they are requiring more than routine care.		Many, apparently well seeming, infants delivered less than 36 weeks end up needing to be transferred because of difficulty with feeding and thermoregulation. Closely monitor these infants and have a low threshold to send these babies to Anchorage. Babies that deliver 36-37 weeks often do well, but these also need to be monitored and transferred if they are requiring more than routine care.

	===Resources===		===Resources===

JenniferH: /* Circumcision */

2020-11-21T08:26:39Z

Circumcision

← Older revision		Revision as of 08:26, 21 November 2020
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	==Circumcision==		==Circumcision==

	Upon maternal admission, the desire for this elective procedure (if male or unknown gender) for their newborn is asked. Most mothers decline. This procedure is done most commonly prior to discharge, but also can be done outpatient for up to 4 weeks. A detailed consent form must be signed by the mother. Generally, only privileged active medical staff are able to do circumcisions due to the paucity of procedures.		Upon maternal admission, the desire for this elective procedure (if male or unknown gender) for their newborn is asked. Most mothers decline.

			This procedure is done most commonly prior to discharge, but also can be done outpatient for up to 4 weeks. A detailed consent form must be signed by the mother. Generally, only privileged active medical staff are able to do circumcisions due to the paucity of procedures.

	==Preterm and Sick Infants==		==Preterm and Sick Infants==

JenniferH: /* Neonatal Jaundice */

2020-11-21T08:26:08Z

Neonatal Jaundice

← Older revision		Revision as of 08:26, 21 November 2020
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	==Neonatal Jaundice==		==Neonatal Jaundice==

	See [[media:Jaundice_neonatal.pdf\|YKHC Clinical Guideline for Neonatal Jaundice]] or details on which babies require phototherapy and how to do it on OB unit.		See [[media:Jaundice_neonatal.pdf\|YKHC Clinical Guideline for Neonatal Jaundice]] for details on which babies require phototherapy and how to do it on OB unit.

	'''Bethel newborn bilirubin follow-up''': For babies born on the unit, the nurses will often agree to obtain a follow up bili on a baby on the following day. The patient will have to come directly to the OB unit and a hospitalist physician will need to be responsible for ordering the bili, reviewing the results and determining follow up. This will keep the patient from having to go to the clinic or ER (around sick people) for follow up labs		'''Bethel newborn bilirubin follow-up''': For babies born on the unit, the nurses will often agree to obtain a follow up bili on a baby on the following day. The patient will have to come directly to the OB unit and a hospitalist physician will need to be responsible for ordering the bili, reviewing the results and determining follow up. This will keep the patient from having to go to the clinic or ER (around sick people) for follow up labs

JenniferH at 08:25, 21 November 2020

2020-11-21T08:25:51Z

← Older revision		Revision as of 08:25, 21 November 2020
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	==~~=Bili Lights=~~==		==Neonatal Jaundice==

	See [[media:Jaundice_neonatal.pdf\|YKHC Clinical Guideline for Neonatal Jaundice]] or details on which babies require phototherapy and how to do it on OB unit.		See [[media:Jaundice_neonatal.pdf\|YKHC Clinical Guideline for Neonatal Jaundice]] or details on which babies require phototherapy and how to do it on OB unit.
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	'''Bethel newborn bilirubin follow-up''': For babies born on the unit, the nurses will often agree to obtain a follow up bili on a baby on the following day. The patient will have to come directly to the OB unit and a hospitalist physician will need to be responsible for ordering the bili, reviewing the results and determining follow up. This will keep the patient from having to go to the clinic or ER (around sick people) for follow up labs		'''Bethel newborn bilirubin follow-up''': For babies born on the unit, the nurses will often agree to obtain a follow up bili on a baby on the following day. The patient will have to come directly to the OB unit and a hospitalist physician will need to be responsible for ordering the bili, reviewing the results and determining follow up. This will keep the patient from having to go to the clinic or ER (around sick people) for follow up labs

	===Circumcision===		==Circumcision==

	Upon maternal admission, the desire for this elective procedure (if male or unknown gender) for their newborn is asked. Most mothers decline. This procedure is done most commonly prior to discharge, but also can be done outpatient for up to 4 weeks. A detailed consent form must be signed by the mother. Generally, only privileged active medical staff are able to do circumcisions due to the paucity of procedures.		Upon maternal admission, the desire for this elective procedure (if male or unknown gender) for their newborn is asked. Most mothers decline. This procedure is done most commonly prior to discharge, but also can be done outpatient for up to 4 weeks. A detailed consent form must be signed by the mother. Generally, only privileged active medical staff are able to do circumcisions due to the paucity of procedures.

	===Preterm and Sick Infants===		==Preterm and Sick Infants==

	Call the pediatric hospitalist for any anticipated (or unanticipated) preterm deliveries, high-risk delivery or sick infant. Make sure nursing staff are preparing for a sick infant and RT and pharmacy are requested. Get more physician help if possible. Peds may need help activating, getting consents and paper work completed and extra hands in resuscitation.		Call the pediatric hospitalist for any anticipated (or unanticipated) preterm deliveries, high-risk delivery or sick infant. Make sure nursing staff are preparing for a sick infant and RT and pharmacy are requested. Get more physician help if possible. Peds may need help activating, getting consents and paper work completed and extra hands in resuscitation.
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	Many, apparently well seeming, infants delivered less than 36 weeks end up needing to be transferred because of difficulty with feeding and thermoregulations. Closely monitor these infants and have a low threshold to send these babies to Anchorage. Babies that deliver 36-37 weeks often do well, but these also need to be monitored and transferred if they are requiring more than routine care.		Many, apparently well seeming, infants delivered less than 36 weeks end up needing to be transferred because of difficulty with feeding and thermoregulations. Closely monitor these infants and have a low threshold to send these babies to Anchorage. Babies that deliver 36-37 weeks often do well, but these also need to be monitored and transferred if they are requiring more than routine care.

	====Resources====		===Resources===
	*[[media:Neonatal resuscitation summary.pdf\|Neonatal Resuscitation Summary Chart]] (pdf)		*[[media:Neonatal resuscitation summary.pdf\|Neonatal Resuscitation Summary Chart]] (pdf)
	*[[Premie_Warm_Welcome_Protocol\|YKHC Premie Warm Welcome Protocol]]		*[[Premie_Warm_Welcome_Protocol\|YKHC Premie Warm Welcome Protocol]]

JenniferH: /* Scenarios/ Special Situations */

2020-11-21T08:25:18Z

Scenarios/ Special Situations

← Older revision		Revision as of 08:25, 21 November 2020
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	==~~Scenarios/ Special Situations~~==		===Bili Lights===
	~~'''~~Bili Lights~~:'''~~

	See [[media:Jaundice_neonatal.pdf\|YKHC Clinical Guideline for Neonatal Jaundice]] or details on which babies require phototherapy and how to do it on OB unit.		See [[media:Jaundice_neonatal.pdf\|YKHC Clinical Guideline for Neonatal Jaundice]] or details on which babies require phototherapy and how to do it on OB unit.
Line 6:		Line 5:
	'''Bethel newborn bilirubin follow-up''': For babies born on the unit, the nurses will often agree to obtain a follow up bili on a baby on the following day. The patient will have to come directly to the OB unit and a hospitalist physician will need to be responsible for ordering the bili, reviewing the results and determining follow up. This will keep the patient from having to go to the clinic or ER (around sick people) for follow up labs		'''Bethel newborn bilirubin follow-up''': For babies born on the unit, the nurses will often agree to obtain a follow up bili on a baby on the following day. The patient will have to come directly to the OB unit and a hospitalist physician will need to be responsible for ordering the bili, reviewing the results and determining follow up. This will keep the patient from having to go to the clinic or ER (around sick people) for follow up labs

	~~'''~~Circumcision~~:'''~~		===Circumcision===

	Upon maternal admission, the desire for this elective procedure (if male or unknown gender) for their newborn is asked. Most mothers decline. This procedure is done most commonly prior to discharge, but also can be done outpatient for up to 4 weeks. A detailed consent form must be signed by the mother. Generally, only privileged active medical staff are able to do circumcisions due to the paucity of procedures.		Upon maternal admission, the desire for this elective procedure (if male or unknown gender) for their newborn is asked. Most mothers decline. This procedure is done most commonly prior to discharge, but also can be done outpatient for up to 4 weeks. A detailed consent form must be signed by the mother. Generally, only privileged active medical staff are able to do circumcisions due to the paucity of procedures.

	~~'''~~Preterm and Sick Infants~~:'''~~		===Preterm and Sick Infants===

	Call the pediatric hospitalist for any anticipated (or unanticipated) preterm deliveries, high-risk delivery or sick infant. Make sure nursing staff are preparing for a sick infant and RT and pharmacy are requested. Get more physician help if possible. Peds may need help activating, getting consents and paper work completed and extra hands in resuscitation.		Call the pediatric hospitalist for any anticipated (or unanticipated) preterm deliveries, high-risk delivery or sick infant. Make sure nursing staff are preparing for a sick infant and RT and pharmacy are requested. Get more physician help if possible. Peds may need help activating, getting consents and paper work completed and extra hands in resuscitation.
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	Many, apparently well seeming, infants delivered less than 36 weeks end up needing to be transferred because of difficulty with feeding and thermoregulations. Closely monitor these infants and have a low threshold to send these babies to Anchorage. Babies that deliver 36-37 weeks often do well, but these also need to be monitored and transferred if they are requiring more than routine care.		Many, apparently well seeming, infants delivered less than 36 weeks end up needing to be transferred because of difficulty with feeding and thermoregulations. Closely monitor these infants and have a low threshold to send these babies to Anchorage. Babies that deliver 36-37 weeks often do well, but these also need to be monitored and transferred if they are requiring more than routine care.

	[[media:Neonatal resuscitation summary.pdf\|Neonatal Resuscitation Summary Chart]] ~~Links to~~ pdf.		====Resources====
			*[[media:Neonatal resuscitation summary.pdf\|Neonatal Resuscitation Summary Chart]] (pdf)
	[[Premie_Warm_Welcome_Protocol\|YKHC Premie Warm Welcome Protocol]]		*[[Premie_Warm_Welcome_Protocol\|YKHC Premie Warm Welcome Protocol]]


	[[:Category:OB & Newborn\|OB & Newborn Main Page]]		[[:Category:OB & Newborn\|OB & Newborn Main Page]]

← Older revision		Revision as of 06:35, 10 February 2022
Line 32:		Line 32:
	*[[media:Neonatal resuscitation summary.pdf\|Neonatal Resuscitation Summary Chart]] (pdf)		*[[media:Neonatal resuscitation summary.pdf\|Neonatal Resuscitation Summary Chart]] (pdf)
	*[[Premie_Warm_Welcome_Protocol\|YKHC Premie Warm Welcome Protocol]]		*[[Premie_Warm_Welcome_Protocol\|YKHC Premie Warm Welcome Protocol]]
			*[[media:Late_preterm.pdf\|Care of Late Preterm Newborns YKHC Clinical Guideline]]


	[[:Category:OB & Newborn\|OB & Newborn Main Page]]		[[:Category:OB & Newborn\|OB & Newborn Main Page]]