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UNM NICU Protocols

Doctors who have completed medical school go to teaching hospitals to complete their residency training. The University of New Mexico Health Sciences Center is one such teaching hospital. In UNM's neonatal intensive care unit, new doctors gain experience in caring for patients under the guidance of experienced doctors. Written protocols govern many of the procedures performed in the NICU. All medical staff members in the NICU are expected to know these protocols.

  1. Neurosurgery Protocol

    • Keeping each room as sanitary as possible is an important part of the neurosurgery protocol. Caregivers are required to wash their hands upon entering each room and before they leave. Incisions must be checked during rounds times. Current orders for patient medications should be entered into the computer system for reference. Before a shift change, the incoming care staff needs to be updated on patients' status and any changes in patient care orders. Any concerns from the nursing staff need to be addressed at rounds, or sooner if the concern is critical. The NICU resident on call is required to update the patient's family at least once a day on the status of the patient and to inform them of any changes in care.

    Trauma Protocol

    • If an infant is admitted to the NICU with signs of trauma, staff members must obtain information about the trauma from the emergency medical services team. A parent or guardian must sign a consent form so that treatment can continue. A physical exam of the infant must be performed as soon as possible. During the exam, reflexes, brain stem reflexes and the infant's movement should all be observed and noted. If signs of cranial trauma are evident, the infant should be sedated and a CT scan ordered. The CT results determine whether the patient can be held for observation or if surgery is required. Doctors must speak to the family to explain the patient's condition and the intended care.

    Shunt Protocol

    • A patient who is brought in with a shunt is moved to the top of the patient list if he exhibits an altered mental state. The parent will be asked if the exhibited behavior is normal. If the child's behavior is abnormal, a CT or MRI scan, depending on the child's age, will be ordered. Staff members will ask the parents if the child has had any viral infection or fever recently. Doctors will compare the new CT or MRI images with past images to look for increased hydrocephalus in the brain. The parents will be consulted and informed of plans to adjust the shunt to re-establish proper draining.

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