NICU

 

NICU Supervisor Ottawa Hospital General Campus:   Dr. Marc Blayney         Tel: 737-8651

 

To meet the rotational goals and objectives, the anesthesia resident will be expected to actively participate in the NICU team duties including call responsibilities, ward and emergency consultations, and care of the NICU patients.  The resident will also have the opportunity to attend elective and emergency operative deliveries at the discretion of the NICU supervisor.  The resident will be expected to assume a progressive increase in patient care responsibilities as they become more senior residents, such that a PGY4 and PGY5 resident should be assuming an active teaching role for more junior residents and function as a resource and consultative role for other residents. 

 

The rotational goals and objectives listed below define the minimum core knowledge content that should be reviewed during the four-week block NICU rotation.  The clinical exposure to each of the knowledge content areas will vary and is not expected to be an-inclusive.

 

Knowledge:

 

1.              To gain an appreciation of the anatomical, physiological and pharmacological considerations for the premature and newborn infant.

 

2.      To gain an appreciation of the presentation, diagnosis, and management of:

   Transient tachypnea of the newborn

   Respiratory distress syndrome

   Bronchopulmonary dysplasia

   Necrotizing enterocolitis

   Fluid, electrolyte, and nutritional management of the newborn

   Interventricular hemorrhage and periventricular leukomalacia

   Phototherapy and management of hyperbilirubinemia in the newborn

   Patent Ductus Arteriosis

   The asphyxiated neonate

   Interpretation of laboratory and X-Ray investigations in the newborn and premature infant.

 

1.    To identify criteria for neonatal follow-up of high-risk infants and understand the role of follow-up in NICU care-decisions.

 

Skills:

 

1.      To gain proficiency in the following procedural skills:

   Establish intravenous access in an aseptic manner in the premature and newborn infant.

   Assess and initiate resuscitation of the asphyxiated newborn.

   Perform tracheal suctioning in the newborn suspected of meconium aspiration.

   Initiate controlled ventilation of the newborn and premature infant.

   Perform blood cultures and lumbar puncture in the septic newborn.

 

Attitude and Communication skills:

 

To resident is expected to demonstrate effective communication skills by:

 

1.    Providing a clear concise summary of the newborn infant.s problems both verbally and in a written format.

2.    Communicate clearly with other health care workers and students concerning the rationale for the proposed medical care of a patient.

3.    Demonstrate a commitment to patient care, even if this entails personal sacrifice.

4.    Honour patient confidentiality and refrain from case discussion in public forums.

5.    Identifying and discussion ethical issues relevant to newborn care.

 

To gain experience and develop communication skills specifically by:

 

1.              Answering questions and keeping the parents abreast of the infants progress in a caring, reassuring and compassionate manner.

2.              Obtaining informed consent from the parents for invasive procedures (e.g., L.P., transfusion, and umbilical catheterization).

3.              Breaking bad news to parents in a compassionate, professional and caring manner.

4.              Defending and explaining to other health care members the rationale for the continuation or withdrawal of treatment.

5.              Participating in teaching rounds.

6.              Participate in teaching activities and supervise other residents and medical students.

 

 

During the Neonatal ICU rotation residents will be rostered to do 6 calls, with the first two nights being supported by an in-house paediatric resident or clinical assistant.  Please remember, the neonatologist is part of the multidisciplinary team (whether in-house or not) and residents should feel free to call him or her at any time.