Forward and Acknowledgements
The Neonatal Intensive Care Unit of the Greenville Hospital System has been in existence for over 40 years. More than 25,000 infants have entered its doors with the vast majority of these infants leaving here as healthy normal children. Most of the infants we care for in our NICU are > 34 weeks gestation; however, in the last 10 years, more than 600 infants < 1500 grams (or < 32 weeks gestation) have received care here. Of those premature infants at highest risk of mortality and morbidity (23 - 25 week gestational age infants), most have survived (65%). Nevertheless, there remains a high risk of short-term morbidities and long-term handicaps in these smallest of infants.
Our success in improving survival and producing intact survivors has been achieved via the hard work and effort of many people including the nurses, nurse practitioners, resident physicians, attending physicians, parents, and many other members of the Children’s Hospital of the Greenville Hospital System and the Greenville community. We hope that everyone continues to acknowledge and appreciate the sacrifices and effort involved in the evolution of this NICU.
Fortunately for everyone concerned with Neonatology, dramatic advances in the understanding of the physiology of the newborn have occurred in recent years leading to substantial improvements in the therapy and technology we are able to offer our sickest newborns. In order to consolidate some of this information and to provide some general management guidelines, we have created this 24th Edition of the GHS Children’s Hospital Neonatal Intensive Care Handbook for the use of the Nurse Practitioners and Resident Physicians working in our NICU. This effort is certainly not perfect - and should never be considered as a substitute for the standard Neonatal text - but we hope to continue to update it yearly and gladly solicit suggestions for its improvement.
Finally, we speak for all of the Neonatologists when we say that we would like to personally acknowledge the support of our families in tolerating our commitment to the GHS NICU and we are continually grateful to our mentors and colleagues in the more traditional academic settings. But most of all, we would like to thank the staff of our NICU for making this such a pleasant place to work and for providing the outstanding care that has allowed so many of the children of this community to live happy and healthy lives.
Whit Walker, MD, MS Bryan Ohning, MD, PhD
Benton Cofer, MD Jeffery Ruggieri, MD
Senior Editors 2007
Edited for 2018 by Matt Halliday, MD
This handbook is written expressly for the use of the Residents, Nurse Practitioners, and Nurses of the Children’s Hospital of Greenville and is intended to serve as a general instruction and reference manual for management of infants in the Neonatal Intensive Care Unit. Although the Neonatologists of Pediatrix Medical Group of South Carolina support its general principles and opinions, this Handbook should never serve as a replacement for standard neonatal Textbooks and this Handbook’s recommendations should only be used in conjunction with input from the attending Neonatologists.
Our success in improving survival and producing intact survivors has been achieved via the hard work and effort of many people including the nurses, nurse practitioners, resident physicians, attending physicians, parents, and many other members of the Children’s Hospital of the Greenville Hospital System and the Greenville community. We hope that everyone continues to acknowledge and appreciate the sacrifices and effort involved in the evolution of this NICU.
Fortunately for everyone concerned with Neonatology, dramatic advances in the understanding of the physiology of the newborn have occurred in recent years leading to substantial improvements in the therapy and technology we are able to offer our sickest newborns. In order to consolidate some of this information and to provide some general management guidelines, we have created this 24th Edition of the GHS Children’s Hospital Neonatal Intensive Care Handbook for the use of the Nurse Practitioners and Resident Physicians working in our NICU. This effort is certainly not perfect - and should never be considered as a substitute for the standard Neonatal text - but we hope to continue to update it yearly and gladly solicit suggestions for its improvement.
Finally, we speak for all of the Neonatologists when we say that we would like to personally acknowledge the support of our families in tolerating our commitment to the GHS NICU and we are continually grateful to our mentors and colleagues in the more traditional academic settings. But most of all, we would like to thank the staff of our NICU for making this such a pleasant place to work and for providing the outstanding care that has allowed so many of the children of this community to live happy and healthy lives.
Whit Walker, MD, MS Bryan Ohning, MD, PhD
Benton Cofer, MD Jeffery Ruggieri, MD
Senior Editors 2007
Edited for 2018 by Matt Halliday, MD
This handbook is written expressly for the use of the Residents, Nurse Practitioners, and Nurses of the Children’s Hospital of Greenville and is intended to serve as a general instruction and reference manual for management of infants in the Neonatal Intensive Care Unit. Although the Neonatologists of Pediatrix Medical Group of South Carolina support its general principles and opinions, this Handbook should never serve as a replacement for standard neonatal Textbooks and this Handbook’s recommendations should only be used in conjunction with input from the attending Neonatologists.