Checklist for the Neonatal Intensive Care Unit

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Things to find out Ask your nurse what clothing is most appropriate; you want something that is easy to get on and off especially if your baby requires help breathing. You may not be able to clothe your baby straight away but the nurses will let you know when it’s ok. Ask what you can do to help care for your baby; like bed baths, changing nappies, kangaroo care, and baby massage Ask about the machines if you’re not sure what they do Ask about information or training sessions; some hospitals provide training for tube feeding or other care based tasks Ask for foot and hand prints if you want them Ask if the NICU has a video camera; some hospital have one for families to use and just ask that your bring your own film/memory card Ask if you can get free parking at the hospital; some hospitals offer parking discounts for families of long-term patients Ask if the hospital offers meals or meal vouchers Ask if there is accommodation nearby if you live a long way from the hospital; you may qualify for accommodation at the Ronald McDonald House Ask what the restrictions are on visitors; of course you’re entitled to place your own restrictions on how many family members and friends you want around at any one time Ask any of the above again, if you forget the answer or you just need clarification

Things to bring Preemie sized clothing; pop your baby’s name on it in case it goes missing A bag for dirty clothes An expressing kit; sterile bottles, containers, and jars, shields, valves and tubing for the pump, cooler bag, electric or hand pump Your baby’s hospital labels and pen Tissues; the nurseries seem to run out often A camera; as well as taking photos of your baby some parents like to take a few of the NICU and the medical equipment so they can document their baby’s progress. Some families like to put other items in the picture with their preemie to get a size comparison, for example, a teddy bear, your hand, or ring A journal, book, laptop, ipad, ipod, smartphone; it canhelp with isolation of the NICU. You can jot down things as they happen, record any changes, include medical information like how much oxygen, types of treatment, weight, or anything else you feel like recording. You can also look up preemie for informatioon or communicate with others A frozen meal, Water & snacks; can be a easy alternative for lunch or dinner and can act as your cool pack for transporting your expressed breast milk Hand moisturiser; you’ll find that you will have to wash your hands with antiseptic hand wash many times in a day, which can dry out your hands so a small tube of moisturiser can be a good remedy

Various other tips If you’ve had twins or triplets, some parents like to put a specific toy with each of their babies when they take photographs, (e.g. a different colour for each baby) so that down the track it is easy to see who is who in each photo Keep a diary or journal; you can include all the medical information about your baby, as well as what you’re thinking and feeling. Some parents report that it gives them a really good way of venting and keeping track of changes over time. Blanket for yourself & boppy pillow; makes it easier to hold baby especially when wires hooked up to various machines Check the hospital noticeboards for information for parents and family; there may be information sessions or morning teas you might like to attend Decorate your baby’s space to make your surroundings feel a little more personal © 2011 preemiehelp all rights reserved

NICU Procedures

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- checklist

NICU Lab work

Notes

Blood glucose Complete blood count (CBC)/hematocrit (Hct) Arterial blood gas (ABG) Capillary blood gas (CBG) Electrolytes Culture & sensitivity Bilirubin Metabolic screening Medication levels Other...

Intravenous Medications

Notes

Intravenous (IV) Intramuscular (IM) Aerosol (breathing) Oral Topical Other...

NICU Procedures

Notes

Glucose test strip X-ray Sepsis Ultrasound Computed tomography (CT) scan Echocardiogram (ECG) Magnetic resonance imaging (MRI) Electroencephalogram (EEG) Other...

NICU Procedures

Notes

Nasogastric tube Orogastric tube Gastrostomy tube Pump Infant formula Breast milk additives Other...

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Understanding my Preemie

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- checklist

Behavioral States

Behavioral Cues of Stress

Deep sleep

Yawning

Light Sleep

Sneezing

Drowsy

Hiccups

Quiet Alert

Gagging

Active Alert

Straining

Crying

Coughing Squirming Arching

Behavioral Signs of Comfort

Grimacing, stressed or stiff look on their face

Lying with relaxed arms and legs

Tongue thrust

Has eyes open and shiny, looking alert

Twitching

Face is relaxed and smooth rather than stiff, or with lines or furrows

Stiff or tense arms, legs or body

Orientation to voice or sound Smooth state change (sleep to wake) Snuggling Smooth movements Concentrated frowning Tries to curl over sideways Has pink, even skin colour In Older preemies Looks at you, or an object with interest, rather than staring blankly Might try to smile

Limp posture Sudden or jerky movements Finger splay Eyes floating Looking away Staring Glazed look

Strong signs of distress Sudden state change, such as crying and fussing changing to drowsy or sleep Is being frantically active and cannot seem to calm down Blotchy, paler, dusky or very red skin color Changes is breathing

Signs of self-comfort

Breathing fast and/or heartbeat has suddenly speeded up

Clasps hands together

Changes in oxygen levels

Brings hands up to mouth or face Sucks on fingers or hands Holds onto the corner of their blanket Has feet, one on top of the other Tucks into a cosy & curled-up position Turns gaze or head away Electroencephalogram (EEG)

© 2011 preemiehelp all rights reserved

Questions to ask your Neonatologist

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- checklist

Before Delivery Who will be there to care for my baby? Will I be able to hold my baby? What does it mean if she doesn’t make any noise when she’s born? Can someone take me & my partner on a tour of the NICU before my baby is born? Metabolic screening Medication levels

Difficult Decisions Who will be making decisions about how much medical treatment my baby will be offered in the delivery room? Will my wishes be taken into account? Can someone help us decide on issues of resuscitation & medical treatment before the delivery?

After Delivery What are my baby’s chances of survival? Is she at risk for any short-term problems?

Is she at risk for any long-term problems? Will I be able to breastfeed her? How long will I have to wait til I can see my baby? When will I be able to hold her? When are friends and relatives able to visit? What are my baby’s care plans for...leaving the incubator, feeding plan, weaning baby off the ventilator?

Being Involved & Informed Who will update me on my baby’s progress? Will they help understand procedures and terms I don’t understand? Will I be able to contribute to any medical decisions? What can I do to help in the NICU? Can I do kangaroo care? What if questions, like what if the medication doesn’t work, what if we decide not to agree to surgery...?

Coming Home How long will my baby be in the hospital? What do I need to prepare at home before baby arrives? Will I have to perform any medical care treatments at home? What support will I have access to once home?

© 2011 preemiehelp all rights reserved

Takes baby’s weight

Special bed to help regulate temperature

Scales

Incubator or isolette

Monitors the amount of oxygen in the surrounding air

Used to treat jaundice, lamp unit that shines blue light onto baby’s bare skin

Used to treat jaundice, uses fibreoptic tubes that emit bright light

Monitors the amount of oxygen in the baby’s blood by using an infrared light sensor

Takes blood pressure at programmed intervals

Measures skin surface oxygen and carbon dioxide

Description

Extra oxygen can be delivered straight into an incubator or via an oxygen mask

Delivers oxygen via a plastic tube which fits behind the ears, and 2 prongs placed in the nostrils

The humidifier moistens and warms the gases

Delivers slightly pressurised air during the breathing cycle through a specially designed nasal mask or pillows

A ventilator can help your baby breathe, or can breathe for them

A plastic tube placed into the windpipe through the mouth or nose

This device monitors breathing and sounds an alarm if your baby stops breathing for more than a preset time limit (e.g. 10- 20 s)

Description

An IV is a thin, flexible tube inserted into one of your baby’s main veins

Allows blood to be taken from an infant at different times, without repeated needle sticks

Allows fluids and medications to be given without having to frequently replace an intravenous (IV) line

Is a long, thin, flexible tube inserted into one of the large veins of the arm near the bend of the elbow.

Are used to deliver intravenous antibiotics

Ambient oxygen analyzer

Phototherapy unit

Biliblanket

Pulse oximeter

Blood pressure monitor

Transcutaneous monitor 

Respiratory Equipment

Extra oxygen & oxygen masks

Nasal cannula

Humidifier

Continuous positive airway pressure (CPAP)

Ventilator

Endotracheal tube

Apnoea alarm

Lines

IV line (Intravenous line)

Umbilical catheter (arterial)

Umbilical catheter (venous)

Peripherally inserted central catheter (PICC) line

Percutaneous line

Cardiorespiratory (heart/breathing) monitor) Measures the heart and breathing rate of your baby

Description

- checklist

General Equipment

NICU Equipment

Notes

Notes

Notes

© 2011 preemiehelp all rights reserved

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