Pediatric NICU (in MKE)

Pediatric NICU - Milwaukee: PEDIAT 930

Welcome to Pediatric NICU-Milwaukee! We are so happy that you are choosing to learn more about the Pediatric NICU elective! During your time with us, you should learn to: Perform a complete examination of a newborn requiring intensive care Recognize differences between term and preterm infants of varying gestational ages Recognize the presenting signs of common neonatal diseases and congenital anomalies Identify common laboratory and radiology studies used in neonatal intensive care Understand the basics of neonatal respiratory care, IV therapy, enteral nutrition, and medications

Course Director Jeffrey Garland, MD Division Coordinator Sacha Ehley (Milwaukee)

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People to Know:

1. 1. Miles Tsuji, M.D. Neonatology Director 414-219-5510 (NICU phone)
   2. Kari Winder, Medical Education Coordinator, Aurora Clinician Student Service
      P:414-219-5004 | E: kari.winder@aah.org

Recommended for:

1. Fourth year students who have a strong interest in pediatrics, especially inpatient pediatrics and intensive care.
2. Fourth year students who have a strong interest in obstetrics

Prerequisites:

1. Completion of the third year of medical school ( Fourth year students only).
2. Completion of a core inpatient rotation in pediatrics
3. Completion of a core inpatient rotation in ObGyn
4. Completion of a core Medicine rotation

Site Information

The Advocate Aurora Neonatal Intensive Care unit is a level III NICU with a typical daily census of 20 to 30.  The hospital is located in downtown Milwaukee and it’s NICU and L&D department serve a diverse patient population including many high-risk maternal referrals from Milwaukee and smaller community hospitals.

The NICU cares for neonates of all gestational ages and is staffed by a team of attending neonatologists.  Each NICU patient has a primary neonatologist.  The rounding model is hence different than the typical academic center. Students will be taught directly by the attending neonatologists.

Expectations

Before the rotation, students should review common neonatal disease process including transient tachypnea of the newborn, respiratory distress syndrome, hyperbilirubinemia, neonatal infections, congenital heart disease, common genetic syndromes, and issues of prematurity.  They should review normal term newborn behavior, physical exam findings, and expected clinical course in the neonatal period as taught in Pediatric Core Rotations.

Students must be expert in the use of the EPIC electronic healthcare record system.  As fourth year students, they will be expected to know how to write H&P and progress notes and present patients concisely and coherently.  They should be able to draw on their experience from their core pediatric rotation and from outside reading to generate appropriate differential diagnoses to neonatal problems.

Students will:

1. Attend morning rounds in the NICU at 0800 hours.
2. Review daily Xray findings on NICU patients
3. Round on assigned NICU patients, writing at least one progress note per day and H&P notes on assigned new patients
4. Present patients to the attending physician including a summary of the interval history, daily physical exam, pertinent laboratory and radiology findings, enteral and parenteral nutrition, assessment including a differential diagnosis of current problems, and plan for the day.
5. Attend high risk deliveries with the neonatal team as opportunities arise.
6. Give a 15 minute presentation on a topic of their choice in the final week of the elective.

Educational Opportunities

Neonatal follow through clinic for former Neonatal intensive care patients – Wednesdays

Educational Resources

Fanaroff  A and Fanaroff J, Care of the High-Risk Neonate, Elsevier Saunders, Philadelphia, 6^th Edition 2013

Cloherty J, Eichenwald E, Hansen A, Stark A, Manual of Neonatal Care, Lippincott Williams & Wilkins, Philadelphia, 7^th Edition, 2012

Feedback

1. Mid-rotation feedback
2. End of rotation feedback