Neonate Intensive Care Unit (Nicu) : Saudi Board Anesthesia Curriculum
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Hany ElbarougyNeonate Intensive Care Unit (Nicu) : Saudi Board Anesthesia Curriculum
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Hany ElbarougyNEONATE INTENSIVE CARE UNIT (NICU)
The neonatal critical care rotation is intended to allow residents to function effectively as
members of the neonatal team to feel comfortable in the recognition and management of
neonatal problems, to become competent in the performance of procedures and to become
able to communicate fully with families. Responsibility is gradually increased as
appropriate to the resident's capability and seniority.
1. Medical Expert
General requirements:
a) Understand the physiological, anatomical and pharmacological considerations for
the premature and neonate.
b) Perform a history and physical assessment of a neonate requiring admission to
the NICU.
c) Be able to identify neonatal patients requiring resuscitation.
d) Understand the principles of neonatal resuscitation.
e) Gain an appreciation of the presentation, diagnosis and management of the
following:
Transient tachypnea of the newborn
Respiratory distress syndrome
Bronchopulmonary dysplasia
Pulmonary interstitial emphysema
Necrotizing enterocolitis
Intraventricular hemorrhage
Hyperbilirubinemia
Neonatal asphyxia
f) Interpret laboratory results and CXR in the newborn and premature infant.
g) Assess and initiate resuscitation of the asphyxiated newborn according to NRP
guidelines.
h) Gain proficiency in the following procedural skills:
Intravenous access in the premature and newborn infant, including
umbilical vein/artery catheterization
Mask ventilation, oral intubation, and nasal intubation of the newborn
infant
Tracheal suctioning in the newborn suspected of meconium aspiration
Initiation of controlled ventilation of the newborn and premature infant
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CPR
Perform lumbar puncture in the septic newborn
Specific requirements:
a) Develop a management plan for the following neonatal surgical emergencies:
necrotizing enterocolitis, patent ductus arteriosus, congenital diaphragmatic
hernia, tracheoesophageal fistula, omphalocele, gastroschisis.
2. Communicator
General requirements:
a) Provide a clear concise summary of the newborn problems both verbally and in a
written format.
b) Communicate clearly with other healthcare workers and students.
c) Explain procedures in a clear manner and obtain informed consent from the
parents for invasive procedures (e.g. lumbar puncture, transfusion in the
newborn).
d) Deliver bad news to parents in a compassionate, professional and caring manner.
3. Collaborator
General requirements:
a) Understand the role of the neonatologist in the peripartum management of the
neonate
b) Work effectively as an integral member of the NICU team
c) Demonstrate an increasing sense of responsibility and case ownership
d) Understand the role and importance of each member in the care of the NICU
patient
Specific requirements:
a) Encouraging input from the multidisciplinary team members
b) Synthesize and communicate a clear plan to the team members
4. Manager
General requirements:
a) Be able to utilize resources effectively
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b) Understand the difficulties of decision making related to resource allocation
c) Practice according to national standards and provincial guidelines for the
management of neonatal intensive care patients
5. Health Advocate
a) Demonstrate a commitment to patient care
b) Provide expertise and leadership in maintaining and improving the standards of
neonatal intensive care
c) Be an advocate to the family and the patient in the medical environment;
understand the complex emotional and ethical situations that arise in this
environment
6. Scholar
a) Have the ability to critically review the literature to understand and evaluate new
information and research
b) Contribute to the learning of others; teach medical students about clinical
problems
7. Professional
a) Answering questions and keeping the parents updated of the infants progress in a
caring, reassuring and compassionate manner
b) Honor patient confidentiality and deliver the highest quality care with integrity,
honesty and compassion