Ministry of Health

NZ Government

    
 ©Copyright
 Published: 29/11/2011

General Duties

During the 5-6 weeks on O&G you should examine as many infants as possible. This should include examination of the infants of your obstetric patients. You should follow the babies' progress in hospital, and become familiar with the management of the normal newborn during its first week of life.

In certain hospitals trainee interns will have one week of solely paediatric duties. However, in others the paediatric experience may have to be acquired throughout the length of the rotation, as these hospitals do not have a week dedicated to neonatal paediatrics. Please refer to the next section for further details. You should discuss the objectives of the rotation, and how you will meet them, with your tutor in Neonatal Paediatrics at the beginning of the rotation. During the rotation you should concentrate on normal babies as well as the more stable babies (Level II) in the neonatal unit. It is not expected that you acquire any sophisticated expertise and knowledge of babies in intensive care although it is helpful to gain exposure to these infants by attending at least one day of Level III ward rounds, if such an opportunity is available. Much of your neonatal experience should be spent in admitting, examining, working up, and reading about babies that are admitted to the neonatal unit.

As opportunity arises you should examine babies with abnormal physical signs. Please use your judgement and always obtain the mother's consent. You can ask the registrars, neonatal nurse practitioners (NS-ANP) or consultants for suitable cases.

Practical procedures: Do or observe as many of the following as you can; opportunities will vary from hospital to hospital. These procedures are listed on your "Log of Practical Experience in Neonatal Paediatrics" and include:

• Ventilation by bag and mask
• Endotracheal intubation: practise on the model
• Setting up an intravenous infusion
• Blood sampling: heel prick and venepuncture
• Lumbar puncture
• Bladder tap

Whether or not you attempt any of these procedures depends upon the extent of your involvement, and the discretion of the house surgeon/NS-ANP/Registrar, especially if the infant appears to be too difficult or too ill to participate in a teaching exercise.

Keep records of all babies examined and practical procedures witnessed or done on the log sheet (Log of Experience in Neonatal Paediatrics).

Deliveries: You should gain some experience in attending deliveries, with the focus on neonatal resuscitation, with the house surgeon, NS-ANP, or registrar. This should be done during the one week in Neonatal Paediatrics in hospitals that offer this rotation; otherwise you need to arrange this experience through your tutor in Neonatal Paediatrics.