for Attendance at High Risk Deliveries by a Specialist Neonatologist
|Reviewed by Clinical
The need for a specialist
Neonatologist to attend a delivery depends on:
- The experience of the registrar, fellow, or
NS-ANP "on call".
- The level of concern of the obstetric staff.
- The clinical scenario.
There should be good
communication between the neonatologist and both the resident neonatal staff and
the obstetric service. During office hours a "high
risk" case should be discussed with the neonatologist "on duty" for
level 3 and out of hours with the neonatologist "on call".
If an obstetrician has concerns
regarding a potential delivery and wishes a specialist neonatologist to attend
that delivery the specialist obstetrician should speak directly to the
is envisaged that:
<28/40 should be discussed so the neonatologist has the option of
attending the delivery.
of infants <26 weeks must be attended by a staff member who is
experienced in stabilising such infants (i.e.an experienced senior registrar, NS-ANP, or
specialist). This should be
discussed with the neonatologist in advance.
If in doubt, the neonatologist should always be called.
of infants with fetal hydrops or life-threatening congenital anomalies (e.g.
diaphragmatic hernia or other conditions) requiring immediate decisions
regarding resuscitation should be attended by a neonatologist.
any case in which the infant resuscitation was unexpectedly complex or where
there is a poor response to resuscitation the attending
should be called urgently.
attending neonatologist should be notified shortly before or as soon as
practicable following the admission of infants to level 3 care who are:
or <1000 g or ventilated or have significant
sick baby causing concern for medical or senior nursing staff.
circumstance where the resident staff are inexperienced or not confident in
undertaking a treatment or procedure required.