Clinical Pathways: Neonatalogy. September 2014

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1 Clinical Pathways: Neonatalogy September

2 Contents 1 Unexpected Poor Condition at Birth/Early Postnatal Problems in Non-NNU sitea&e (RSH) Out of Hours 2 Unexpected Poor Condition at Birth/Early Postnatal Problems in Non-NNU sitea&e (RSH) In CAU Open Hours 3 Unexpected Poor Condition at Birth/Early Postnatal Problems in Stand Alone MLU/Home birth 4 Unexpected Poor Condition at Birth/Early Postnatal Problems in MLU on non-nnu site (RSH) In Hours 5 Unexpected Poor Condition at Birth/Early Postnatal Problems in MLU on NNU site(prh)

3 1. Unexpected Poor Condition at Birth/Early Postnatal Problems in Non-NNU sitea&e (RSH) Out of Hours Unexpected poor condition at or after delivery in A&E Early postnatal problems in A&E Ambulance phones ahead Patient arrives unannounced Assess patient, commence stabilisation Phone on call Consultant Paediatrician for RSH Phone Neonatal unit for advice admission/unwell/being resuscitated e.g. mild respiratory distress +ambulance from PRH NNU (Guideline to be written transport nursing rota under development IM) Neonatal Nurse and competent medical/practitioner staff* (Guideline to be written WT) Or transitional care (Guideline admission criteria for transitional care) Transfer - NNU or PNW/TC By Midwife RSH MLU + pod (Transfer of stable newborn guideline -midwifery?) (Transfer of newborn from remote A&E to NNU guideline to be written WT) * Competent medical/practitioner staff to be determined

4 2. Unexpected Poor Condition at Birth/Early Postnatal Problems in Non-NNU sitea&e (RSH) In CAU Open Hours Unexpected poor condition at or after delivery in A&E Early postnatal problems in A&E admission/unwell/being resuscitated Call Paediatric Team Or transitional care (Guideline admission criteria for transitional care) Neonate Unwell/being ventilated/collapsed REQUEST A CALL TO NNU FOR HELP Call Paediatric Team Bleep Numbers: SHO 726 Registrar 877 Consultant on Call To help resuscitate and stabilise the baby e.g. mild respiratory distress & Call Paediatrician +ambulance from PRH NNU (Guideline to be written transport nursing rota under development IM) Neonatal Nurse and competent medical/practitioner staff* (Guideline to be written WT) Transfer - NNU or PNW/TC By Midwife RSH MLU + pod (Transfer of stable newborn guideline -midwifery?) (Transfer of newborn from remote A&E to NNU guideline to be written WT) * Competent medical/practitioner staff to be determined

5 3. Unexpected Poor Condition at Birth/Early Postnatal Problems in Stand Alone MLU/Home birth Unexpected poor condition at or after delivery in MLU/Home birth Early postnatal problems in MLU/Home birth admission/unwell/being resuscitated e.g. phototherapy, transitional care Neonate Unwell/being ventilated/collapsed REQUEST A CALL TO NNU FOR ADVICE Resuscitate baby (Resuscitation of the newborn in MLU/Home birth guideline) (Stabilisation of newborns in MLU to be written WT) Call for urgent ambulance Transfer - NNU By Midwife MLU & Paramedic + pod TRANSPORT ARRANGEMENTS FOR THE MOVEMENT OF A SICK NEWBORN INTO HOSPITAL FROM HOME OR A MIDWIFE-LED UNIT Transfer - PNW/TC By Midwife MLU + pod (Transfer of stable newborn guideline -midwifery?)

6 4. Unexpected Poor Condition at Birth/Early Postnatal Problems in MLU on non-nnu site (RSH) In Hours (Out of hours follow Stand Alone MLU Flowchart) Unexpected poor condition at or after delivery in MLU Early postnatal problems in MLU admission/ unwell/ being resuscitated) Commence Resuscitation e.g. phototherapy, transitional care Call Paediatric Team Bleep Numbers: SHO 726 Registrar 877 Consultant on Call e.g. mild respiratory distress To help resuscitate and stabilise the baby Neonate Unwell/being ventilated/ collapsed REQUEST A CALL TO NNU FOR HELP & Call Paediatrician (Stabilisation of newborns in remote A&E departments +ambulance from PRH NNU (Guideline to be written transport nursing rota under development IM) Neonatal Nurse and competent medical/practitioner staff* (Guideline to be written WT) Transfer - NNU or PNW/TC By Midwife RSH MLU + pod (Transfer of stable newborn guideline -midwifery?) Transfer of newborn to NNU from remote A&E guideline to be written WT) * Competent medical/practitioner staff to be determined

7 5. Unexpected Poor Condition at Birth/Early Postnatal Problems in MLU on NNU site(prh) Unexpected poor condition at or after delivery in MLU Early postnatal problems in MLU admission/ unwell/ being resuscitated e.g. phototherapy, transitional care Neonate Unwell/being ventilated/collapsed REQUEST A CALL TO NNU FOR HELP Crash Call neonatal team to assist & lead on care, and Resuscitate baby (Resuscitation of the newborn on the consultant labour ward SaTH v2) Call neonatal team to assist & lead on care (Stabilisation of newborns guidance is within transporting sick newborn guideline) (Stabilisation of newborns in MLU to be written WT) Neonatal Nurse and neonatal Dr/ANNP( TRANSPORT ARRANGEMENTS FOR THE MOVEMENT OF A SICK NEWBORN FROM WITHIN RSH BUT OUTSIDE OF MATERNITY BLOCK, TO NEONATAL UNIT can be adapted WT) Inform NNU neonatal unit of admission & transfer Transfer - NNU By Midwife MLU + pod with neonatal Dr/ANNP (Transfer guideline within site from MLU On site to be written WT/midwives ) Transfer - PNW/TC By Midwife PRH MLU + pod (Transfer of stable newborn guideline -midwifery?)

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