NICU: ORANGE ENDORSEMENTS 2019

Prepared by: JI Raina Karmjet L. Manuel

⚠ ​HAVE A VIBER ACCOUNT! IT'S THE ONLY MEDIUM YOU MAY HAVE TO
COMMUNICATE WITH YOUR SUBGROUP AND RESIDENTS! THEY MAY ASK YOU TO
SEND WET READINGS OF X-RAYS, CT, UTZ OF ADMITTED PATIENTS!
⚠ ALWAYS DO YOUR PROGRESS NOTES EVERYDAY.
⚠ COMPLETE YOUR CHARTS!
⚠ IF YOU WILL HAVE ADCON BY 7:30 or 8AM, BE EARLY.

💠PRE-DUTY💠
🔹What to bring:
1. Labgown (Wear it whenever you'll go inside the special areas. Also have face mask and head
cap)
2. Stethoscope (For checking patients for the progress notes or assessment)

🔸Be early because you have to get the BCG vaccine from PEDIA OPD. (1vial + 1ampule)

🔸Ask the From Duty, how many are for MGH in the OB ward and Septic Unit
🔸Call Pay Ward if there is any for NBS, NBHS, and BCG

🔸Prepare the vaccine.

🔸🔸Aspirate from the ampule and mix with the vial
🔸🔸After mixing and shaking the vial well, aspirate the mixture. From the syringe, you may
aspirate 0.05ml per insulin syringe.
🔸🔸1vial = 20 filled insulin syringe
🔸🔸If you have more than 20 patients, get another BCG from OPD
🔸🔸If you finished it ahead of time, you can store it in the refrigerator (door side compartment)
(OB WARD)
🔸🔸You may also prepare:
1. 1 tray (You will need it for you to place the ice pack and the filled insulin syringes)
2. 2 empty containers (for the discarded lancets and cotton)
3. Dry cotton with the container (OB)
4. Cushion or cloth from the basinette in the phototherapy area

🔸Get the tackle box (box with NBS strips and everything) along with the NBHS device and
logbooks (3 logbooks)

🔸Log the name of the babies (for MGH) on the BCG Logbook as well as in the Hearing
Screening Logbook.
🔸If your residents will allow you, you may fill-up the strips (Carefully handle the strips
especially the side on which the blood will be collected. Also, don't let the strips be folded in any
way. And avoid erasures as much as possible)
🔸🔸Refer to the information to be filled-up on the Newborn Nursery Record Form

🔸Fill-up NB Hearing Form completely

🔸After you finish everything, you may now call the mothers to bring their babies to your area.
🔸You will do things simultaneously:
1. BCG vaccination
2. NBS
3. NBHS
🔸🔸If the result would include "refer", you may write in the result form a reminder for them to
come back after 3 months for repeat screening.

🔸Let the strips dry for a quite some time.

🔸Arrange the strips chronologically and alternately (Never have the strips adhere on the same
side)
🔸Log the information in the logbook.

🔸After everything is done, you put back everything into place. Return the things you got from
OB. Return the tackle box, hearing device, and logbooks in NICU.
🔸You may now start to have progress notes in NICU.
🔸Your resident may also ask you to do CF4 and clinical abstracts.
🔸If there are patient in NICU that are for MGH, you will fill-up the Tagubilin differently. You
have to include the latest anthropometrics vs the admitting anthropometrics, the latest lab
results, and the vaccines that were given to the patient.
🔸🔸You should also have some prescriptions because NICU has only a limited supply of the
prescription.

💠DUTY💠
🔹What to bring:
1. Prepared charts and Tagubilins
2. Labgown (Use it if you will go out of the special areas)
3. Stethoscope

🔸Prepare and complete the tackle box for DR/OR

🔸🔸ASK FROM NICU CLEAN: 2 suction tube, oxygen tube, feeding tube, 2 pcs of Fr 8 and Fr
5 feeding tube; ambu bag, ambu bag mask; ET tube : 2.5, 3, 3.5, 4 (2 pcs each); and sterile
gloves.
🔸🔸Place it under the basinette in DR.

🔸If you have high-risk patients, you may refer to your resident ahead of time.
🔸🔸You may refer to your resident with this format:

Name of mother:
Age of mother:
AOG by LMP/UTZ:
(If preterm pls indicate funric height and estimated fetal weight)
G/P
PROM
Maternal Illness/Comorbidities
Meds taken
Tetanus toxoid
Latest IE
If for cs, give the indication

🔸🔸If the mother is for CS, let the OB clerks notify your resident. After the slip was signed,
staple the slip with the Maternal History Form.
🔹🔹🔹Update your resident if the mother is roomed-in in the OR, if the mother was already
inducted, for draping and for cutting.

🔸🔸If the delivery will be for AVD or VADS, inform your resident, as well.
🔸🔸If the mother is at high risk but still for NSD, inform your resident that the patient is at the
DR already.

⚠ Always be informed about the status of the fetus. Never catch if it is already IUFD. If the baby
is already bradycardic, inform your resident.
⚠ Have timely updates to your resident.

💠FROM DUTY💠
1. Have rounds with your residents.
2. Do your Tagubilins. Inform the Pre-duty Clerk on how many patients are for MGH.
3. Do your progress notes: OB, Septic Unit, and NICU.