Provision and Location of Intensive Care
|Reviewed by Carl
Kuschel, John Beca (PICU), and Philip Morreau (Paediatric Surgery)
All surgical neonates who require
intensive care in the neonatal period will be looked after before and after
surgery in NICU.
The exceptions to this are:
- Infants with
congenital diaphragmatic hernia
- Delivery will be attended by the Neonatal
Team and they will be stabilised in NICU and then transferred as
soon as practicable to PICU for ongoing management.
- This will generally be after vascular lines
have been inserted and radiographs taken, and we would
anticipate that babies move to PICU within 1-2 hours of birth.
- Infants with a paediatric surgical problem
(e.g. bowel anomaly) whose predominant problem is congenital heart
disease will be transferred to PICU.
- Infants with airway problems will be managed in
- Infants with abdominal wall defects who develop
an abdominal compartment syndrome with renal impairment will be
transferred to PICU.
These guidelines will need to be
flexible. There will be times when one or other unit is full and requires
assistance. In addition, some infants with conditions which would normally
require admission to PICU may be initially managed in NICU if they are
than 7 days or with acute infections
- Infants older than 7 days who have been discharged home
and present with a condition requiring surgery will be admitted to ward 24B
and receive their intensive care support in PICU.
- Babies who clearly have acute infections will be admitted
to PICU or 24B in preference to NICU.
- If babies who have been in NICU are transferred to ward
24B and subsequently require further intensive care, they will be admitted
to PICU if they have been discharged from NICU for more than 72 hours.
- Referral to the surgical service for urgent consultation
or where there are concerns about the clinical condition of the infant will
continue to be neonatal specialist to surgical specialist.
- Non-urgent referrals (for example, inguinal hernias
awaiting elective repair) may be referred from NICU registrar or Nurse
Specialist to surgical registrar.
Ward 24B High Dependency Unit
- Placement of surgical neonates requiring high dependency
care will continue on the surgical ward.
- However, the Neonatal Team will consult as needed and
advise over medical management.
Post-operative Surgical Review
- The surgical team involved in
the surgical care will regularly visit the NICU in the post-operative period
until the baby no longer requires surgical involvement or until the baby is
transferred out of NICU.
- Infants born at Middlemore Hospital who require
surgical procedures will be looked after post-operatively in the ACH NICU
(some infants may be transferred to the ACH NICU prior to surgery if
- Once these infants no longer need surgical review,
they will be transferred back to Middlemore NICU
If you cannot see an index above, please
press the "Refresh" button of your browser.