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Neonatal Intensive Care Unit
Routine Medical Procedures
In the NICU, doctors and nurses perform a number of routine medical procedures and interventions to help each baby, based on his or her medical condition. Some of these include:
Heel Stick
A heel stick is a pinprick to the infant's heel in order to obtain blood samples for routine laboratory testing and also to evaluate blood for the presence of high bilirubin (jaundice) and for the New York State Newborn Screening testing. Heel sticks are usually performed by the baby's nurse.
Peripheral Intra-venous line (PIV)
A baby may have an IV (intravenous) line placed in the hand, foot or scalp, where veins are easily accessed. Clear plastic tubing connects the IV to a bag containing medications, such as antibiotics and/or fluids that provide all nutrition, including carbohydrates, proteins, fats and vitamins that are carefully delivered by a pump.
Arterial Lines
An arterial line is a catheter that looks similar to a PIV but it is placed into a small artery, not a vein. An arterial line is used primarily for the medical and nursing team to monitor an infant's blood pressure continuously and to take frequent blood samples for laboratory testing.
Intubation
This is the process where a breathing tube is placed into the infant's main airway (windpipe) from the nose or mouth. The nurse and doctor prepare the infant for the intubation by positioning the infant so that the airway can be more easily seen. A laryngoscope, which has a light at its tip, is used to help keep the baby's mouth open so that the doctor or nurse inserting the tube can see the airway. The breathing tube is connected to a ventilator/respirator. This procedure helps the baby heal by doing the breathing for him or her.
PICC/PCVL/Long Line/Percutaneous Line
If a baby is going to be in the NICU for period of time and requires prolonged intravenous medications and/or nutrition, a catheter may be placed in a deep vein in the baby’s arm, leg or scalp. The PCVL is designed to stay in place for days or weeks at a time and eliminates the need for repeated PIV insertions to deliver medications and/or IV nutrition/fluids.
Once a baby is well enough to take breast milk or formula feedings and is gaining weight, PCVL lines can often be removed. Sometimes a PCVL may be needed for giving antibiotics or other medications, even when the baby can be fed normally.Nasal-CPAP (Continuous Positive Airway Pressure)
Pressure is the key word to this form of breathing support. The infant requires a small amount of continuous positive pressure to help the lungs expanded. With nasal-CPAP, the baby is doing all the breathing on his or her own. A head cap secures the tubing on the baby's head area with nasal prongs placed snugly on the baby’s nostril. The pressure and oxygen are delivered through this tubing. CPAP is usually considered when a baby no longer needs the full support of a ventilator.
Nasal Canula
A tiny prong is placed into each of the baby's nostrils to deliver oxygen. The infant breathes on his or her own with minimal support from machines. Nasal canula provides a continuous flow of oxygen/air into the baby's nose with a very small amount of pressure.
Umbilical Arterial/Venous Catheter (UAC or UVC)
After the umbilical cord is cut at birth, newborn babies have the short stumps of the cord remaining on their bellies for a week. Because the umbilical cord stump is still connected to their blood and circulatory system, a catheter (small flexible tube) can be inserted into one of the two arteries or the vein of the umbilical cord. This is an effective way to give the baby medications and fluids. After placement of the umbilical catheter, X-rays are taken to check the location in the baby's body.
