The Neonatal Intensive Care Unit at Seattle Children's Hospital shares a 45-bed ICU with the Pediatric ICU and Cardiac ICU. The ICU is scheduled for expansion into a new hospital building, opening in 2013. The average census of NICU patients (including surgical neonates and pre-operative CICU neonates) is 15 with peak census up to 21. The NICU medical team includes a faculty neonatology attending, a neonatal fellow, and 3 second- or third-year pediatric residents. They round daily with the NICU nurses, respiratory therapists, nutritionist, pharmacist, social worker, and patients' families. The NICU team accepts admissions for all neonates up to 44 weeks' corrected gestational age from a 4-state area and from other NICUs for unusual or 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.
The NICU at the University of Washington Medical Center is a 32 bed unit with approximately 400-425 admissions per year. A new 47-bed NICU is under construction and is scheduled to open in 2012. The average NICU census is 24 infants. Over 95% of admissions are inborn from the UWMC High-Risk Perinatal Program. 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.