The Apgar score is a quick way for doctors to evaluate the health of all newborns at 1 and 5 minutes after birth and in response to resuscitation. It was originally developed in 1952 by an anesthesiologist at Columbia University, Dr. Virginia Apgar, as way to address the need for a standardized way to evaluate infants shortly after birth.
Infantile respiratory distress syndrome (IRDS), also called respiratory distress syndrome of newborn, or increasingly surfactant deficiency disorder (SDD), and previously called hyaline membrane disease (HMD), is a syndrome in premature infants caused by developmental insufficiency of pulmonary surfactant production and structural immaturity in the lungs. It can also be a consequence of neonatal infection and can result from a genetic problem with the production of surfactant-associated proteins.
March of Dimes is a United States nonprofit organization that works to improve the health of mothers and babies. The organization was founded by President Franklin D. Roosevelt in 1938, as the National Foundation for Infantile Paralysis, to combat polio. The name "March of Dimes" was coined by Eddie Cantor. After funding Jonas Salk's polio vaccine, the organization expanded its focus to the prevention of birth defects and infant mortality. In 2005, as preterm birth emerged as the leading cause of death for children worldwide, research and prevention of premature birth became the organization's primary focus.
Kangaroo care also called skin-to-skin contact (SSC), is a technique of newborn care where babies are kept chest-to-chest and skin-to-skin with a parent, typically their mother.
Neonatology is a subspecialty of pediatrics that consists of the medical care of newborn infants, especially the ill or premature newborn. It is a hospital-based specialty, and is usually practised in neonatal intensive care units (NICUs). The principal patients of neonatologists are newborn infants who are ill or require special medical care due to prematurity, low birth weight, intrauterine growth restriction, congenital malformations, sepsis, pulmonary hypoplasia or birth asphyxia.
A neonatal intensive care unit (NICU), also known as an intensive care nursery (ICN), is an intensive care unit (ICU) specializing in the care of ill or premature newborn infants. Neonatal refers to the first 28 days of life. Neonatal care, as known as specialized nurseries or intensive care, has been around since the 1960s.
Perinatal asphyxia is the medical condition resulting from deprivation of oxygen to a newborn infant that lasts long enough during the birth process to cause physical harm, usually to the brain. It is also the inability to establish and sustain adequate or spontaneous respiration upon delivery of the newborn. It remains a serious condition which causes significant mortality and morbidity. It is an emergency condition and requires adequate and quick resuscitation measures. Perinatal asphyxia is also an oxygen deficit from the 28th week of gestation to the first seven days following delivery. It is also an insult to the fetus or newborn due to lack of oxygen or lack of perfusion to various organs and may be associated with a lack of ventilation. In accordance with WHO, perinatal asphyxia is characterised by: profound metabolic acidosis, with a PH < 7.20 on umbilical cord arterial blood sample, persistence of an APGAR score of 3 at the 5th minute, clinical neurologic sequelae in the immediate neonatal period, or evidence of multiorgan system dysfunction in the immediate neonatal period. Hypoxic damage can occur to most of the infant's organs, but brain damage is of most concern and perhaps the least likely to quickly or completely heal. In more pronounced cases, an infant will survive, but with damage to the brain manifested as either mental, such as developmental delay or intellectual disability, or physical, such as spasticity.
Pediatric nursing is part of the nursing profession, specifically revolving around the care of neonates and children up to adolescence. The word, pediatrics, comes from the Greek words 'paedia' (child) and 'iatrike' (physician). 'Paediatrics' is the British/Australian spelling, while 'pediatrics' is the American spelling.
Bronchopulmonary dysplasia is a chronic lung disease in which premature infants, usually those who were treated with supplemental oxygen, require long-term oxygen. The alveoli that are present tend to not be mature enough to function normally. It is more common in infants with low birth weight (LBW) and those who receive prolonged mechanical ventilation to treat respiratory distress syndrome (RDS). It results in significant morbidity and mortality. The definition of BPD has continued to evolve primarily due to changes in the population, such as more survivors at earlier gestational ages, and improved neonatal management including surfactant, antenatal glucocorticoid therapy, and less aggressive mechanical ventilation.
Newborn transport is used to move premature and other sick infants from one hospital to another, such as a medical facility that has a neonatal intensive care unit and other services. Neonatal transport services such as NETS use mobile intensive care incubators fitted with mechanical ventilators, infusion pumps and physiological monitors capable of being used in a mobile environment. These transport systems seek to emulate the environment of a neonatal intensive care and permit uninterrupted care to occur in a referring hospital and then during the journey by road or air ambulance. Power and medical gas supplies are carried within the system as well as making use of external supplies; as available. Infant transport systems commonly weigh over 100 kg and present a challenge to vehicle operators in terms of weight, manual handling, crashworthiness and power consumption.
Critical care nursing is the field of nursing with a focus on the utmost care of the critically ill or unstable patients following extensive injury, surgery or life threatening diseases. Critical care nurses can be found working in a wide variety of environments and specialties, such as general intensive care units, medical intensive care units, surgical intensive care units, trauma intensive care units, coronary care units, cardiothoracic intensive care units, burns unit, paediatrics and some trauma center emergency departments. These specialists generally take care of critically ill patients who require mechanical ventilation by way of endotracheal intubation and/or titratable vasoactive intravenous medications.
Rainbow Babies & Children's Hospital is a pediatric acute care children's teaching hospital located in Cleveland, Ohio. The hospital has 244 pediatric beds and is affiliated with Case Western Reserve University School of Medicine. The hospital is a member hospital of University Hospitals and is the only children's hospital in the network. The hospital provides comprehensive pediatric specialties and subspecialties to infants, children, teens, and young adults aged 0–21 throughout northern Ohio. Rainbow Babies & Children's Hospital also sometimes treats adults that require pediatric care. Rainbow Babies & Children's Hospital also features the only ACS verified Level 1 Pediatric Trauma Center in the region. The hospital is one of the largest providers of pediatric health services in Ohio. The hospital is attached to University Hospitals Cleveland Medical Center and a few blocks away from the Ronald McDonald House of Cleveland.
Bubble CPAP is a non-invasive ventilation strategy for newborns with infant respiratory distress syndrome (IRDS). It is one of the methods by which continuous positive airway pressure (CPAP) is delivered to a spontaneously breathing newborn to maintain lung volumes during expiration. With this method, blended and humidified oxygen is delivered via short binasal prongs or a nasal mask and pressure in the circuit is maintained by immersing the distal end of the expiratory tubing in water. The depth to which the tubing is immersed underwater determines the pressure generated in the airways of the infant. As the gas flows through the system, it “bubbles” out and prevents buildup of excess pressures.
Surfactant therapy is the medical administration of exogenous surfactant. Surfactants used in this manner are typically instilled directly into the trachea. When a baby comes out of the womb and the lungs are not developed yet, they require administration of surfactant in order to process oxygen and survive. This condition that the baby has is called newborn respiratory distress syndrome, and it is treatable. Surfactant coat the smallest parts of the lungs called the alveoli and helps for oxygen to go in and for carbon dioxide to go out. How surfactant does this is by not allowing the alveoli to collapse and to retain their inflated shape when the baby exhales.
The Bloxsom air lock was an incubator used in the treatment of respiratory distress among newly born infants in the 1950s. The device attempted to mimic the rhythm of uterine contractions, which were thought to have a role in stimulating fetal breathing. The device was developed by Dr. Allan Bloxsom, a pediatrician at St. Joseph Hospital and Baylor College of Medicine in Houston, Texas. At its peak, the device was utilized in more than 700 hospitals.
A neonatal nurse practitioner (NNP) is an advanced practice registered nurse (APRN) with at least 2 years experience as a bedside registered nurse in a level III NICU, who is prepared to practice across the continuum, providing primary, acute, chronic, and critical care to neonates, infants, and toddlers through age 2. Primarily working in neonatal intensive care unit (NICU) settings, NNPs select and perform clinically indicated advanced diagnostic and therapeutic invasive procedures. In the United States, a board certified neonatal nurse practitioner (NNP-BC) is an APRN who has acquired Graduate education at the master’s or doctoral level and has a board certification in neonatology. The National Association of Neonatal Nurse Practitioners (NANNP) is the national association that represents neonatal nurse practitioners in the United States. Certification is governed by the National Certification Corporation for Obstetrics, Gynecologic and Neonatal Nursing Specialties (NCC).
Julius Hess was an American physician who is often considered the father of American neonatology. In 1922, he published the first textbook focused on the care of prematurity and birth defects in infants. That same year, Hess and nurse Evelyn Lundeen created the first premature infant station in the United States, recognizing the importance of nursing care and temperature management in the care of preterm babies. Hess also made early contributions to the transport of such infants to specialty centers.
Evelyn Lundeen was an American nurse who headed the first premature nursery in the United States with Dr. Julius Hess. Outside of her work at the nursery, Lundeen traveled to other cities to teach the principles of nursing care for premature infants. With Hess, she also co-authored an early textbook on premature baby care.
Neonatal resuscitation, also known as newborn resuscitation, is an emergency procedure focused on supporting approximately 10% of newborn children who do not readily begin breathing, putting them at risk of irreversible organ injury and death. Through positive airway pressure, and in severe cases chest compressions, medical personnel certified in neonatal resuscitation can often stimulate neonates to begin breathing on their own, with attendant normalization of heart rate.
Herbert Barrie, was a British consultant paediatrician and a leading figure in neonatology. He was a pioneer in the emerging specialty of paediatrics and neonatal medicine; and he developed one of the first neonatal intensive care units in London.
