The Neonatal Intensive Care Unit at Seattle Children’ Hospital has 19 licensed Level IV beds and shares space with the Pediatric and Cardiac ICUs for a total capacity of 54 ICU beds. The NICU medical team includes a faculty neonatology attending, a neonatal fellow or neonatal nurse practitioner, and 3 second-year pediatric residents. They round daily with the NICU nurses, respiratory therapists, dietician, pharmacist, social worker, and patients’ families. The NICU team accepts admissions of critically ill neonates up to 44 weeks’ post menstrual age (i.e., up to 4 weeks after due date) from a 5-state area; almost all are transferred from Level III NICUs because of highly complex and challenging problems. Typical diagnoses include respiratory failure, perinatal infection, diaphragmatic hernia, necrotizing enterocolitis, cyanotic congenital heart disease, life-threatening malformations, and complex multi-system failure. Consultation from all pediatric and surgical specialties is available, including services such as extra-corporeal membrane oxygenation, amplitude EEG, dialysis, and innovative surgical and catheter-directed therapies.
A new state-of-the-art 48-bed NICU opened in October 2012. The new unit includes 42 single-bed rooms with space for a family member to stay near their infant, several additional rooms for multiples, and an integrated OR for surgical procedures. The average NICU daily census is 34 infants. Over 95% of admissions are inborn from the UWMC High-Risk Perinatal Program, one of the highest risk obstetric services in the nation and has special expertise in management of the most fragile growth-restricted and premature fetuses and newborns. Patient care is managed in a multidisciplinary fashion by highly trained nurses, respiratory therapists, a neonatal nutritionist, a neonatal pharmacist, neonatal nurse practitioners, pediatric residents, neonatal fellows, and neonatal faculty attendings. Delivery room resuscitation duties are shared by the NICU and newborn nursery medical teams. Daily patient care rounds are directed by the attending neonatologist and neonatal fellows. Neonatal fellows have ample opportunity to perfect and teach resuscitation skills. Fellows also provide prenatal consultations.