Thursday, August 11, 2016

day in the life: NICU

(this is an old post that never was posted from months ago)

I loved my NICU rotation! I only spent one week there but it was amazing watching how to care for the newborns and watch how the providers saved their lives immediately after birth. The NICU is very serious but the staff are kind and were always willing to teach. I don't think I had enough time to really learn how to fully formulate plans for all of the cases in the NICU but I had a great experience learning about what it means to help newborns survive and transition to life at home.

The NICU uses a lot of machines and life sustaining equipment such as tubes for feeding and breathing. It was cool to learn about those too and how they are transitioned through different levels of care related to eating and breathing. 

I would arrive around 6:00 a.m. and start researching my assigned patients in the computer system. I am new to the electronic medical record system so this took me a long time. 

I would record data for each patient such as:
 -amount of calories, protein, lipids the baby had in the last 24 hours
-number of stools and urine output 
-heart rate and episodes of elevated or slow heart ratet-respiratory rate and episodes of slow breathing
-blood pressure abnormalities
-temperature abnormalities
-how the baby was getting nutrition : g button? NG tube? breast feeding?
-what was the nutrition and how many calories?
-how is the baby breathing: room air? ventilator? nasal cannula? what flows? etc.
-any labs or imaging the baby had in the last 24 hours?
-medications the baby is on

Next I would do a limited physical exam on my assigned infants and record any findings.

Then I would try and assess the information and formulate a plan for the next 24 hours for each patient. I would present this information to attendings, residents, nursing staff, other providers, pharmacists, and social workers  in a group where we would discuss the appropriate plan and care for each patient.  

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