Surgical, Neurologic, & Complex Care of the Neonate - PEDIAT 935

Welcome to Pediatric Surgical, Neurologic & Complex Care of the Neonate!

We are so happy that you are choosing to learn more about the Pediatric Complex Care elective!

During your time with us, you should learn to:

Become familiar with etiologies of respiratory distress in the neonate as well as the various forms of ventilator support available.
Describe fluid, electrolyte, nutritional needs of the neonate, especially during the peri-operative period or during times of altered gut motility, and methods by which those requirements are met.
Introduce neurologic concepts such as thermoregulation, apnea of prematurity, analgesic management, hypoxic-ischemic encephalopathy, and neonatal seizures.
Identify infectious risk factors from the birth history and outline methods to both evaluate and treat neonatal infection.
Recognize the indications for common procedures in the NICU, such as endotracheal intubation, central intravenous access, and lumbar puncture, as well as surgeries often considered for infants with chronic medical conditions, such as tracheostomy and gastrostomy.
Summarize universal screening evaluations for the neonate.
Observe surgical procedures at the discretion of the attending physician and particular clinical situation.

Elizabeth McBride
Course Director

Elizabeth McBride, MD

Division Coordinator

Michael Carmi

Expectations

During the AFCH NICU rotation, students are expected to provide in-patient services with the attending neonatologist, nurse practitioners, and hospitalists including:
- Oral presentation on rounds
- Documentation of care with daily progress notes
- Participation in collaborative care with consultant services
- Involvement in procedures as available
- Contribution to multidisciplinary care in conjunction with nutritionists, speech therapists, and other members of the healthcare team
Assignments:
- Submit Mid-Rotation Feedback Form to Canvas
- Give a 15-minute oral presentation on a topic of their choice in the final week of the elective. A neonatal topic of the student’s choosing should incorporate an evidence-based clinical question, on which he or she should provide commentary using current literature.

Educational Opportunities

Surg Neuro CC Schedule.JPG

See https://pediatrics.wisc.edu for current Grand Rounds schedule

Educational Resources:

Avery’s Diseases of the Newborn, 9th ed. (Gleason & Devaskar)
Neonatology: Management, Procedures, On-Call Problems, Diseases, and Drugs, 7th ed. (Gomella)
Neonatal Resuscitation Textbook, 7^th or 8th ed (8^th starts coming out June 2020).
Journal articles pertinent to the care of encountered patients in sources such as Pediatrics, NeoReviews, etc.

Feedback: (Dependent upon whether 2 or 4-week elective)

Mid-rotation feedback on 1^st or 2^nd Friday of rotation
End of rotation feedback on 2^nd or 4^th Friday of rotation
Mid-Rotation feedback form needs to be completed and emailed to Course Director while the End of rotation feedback is just in person, and there is no paper form to upload.

Grading

Grading is Pass/Fail and based on the standard medical school clerkship performance evaluation. Grading criteria will not vary based upon rotation length.

Information/Assignments on CANVAS

There are two assignments for this course.
- The first assignment for this course is listed under “Assignments” on Canvas and includes the “Mid-Rotation Feedback Form
- The second assignment is to create an oral presentation that will be presented to the NICU team on the final week of your rotation. The topic can be of your choice, but should be related to one of the patients that you cared for. You can create a power point presentation if you wish, and the talk should go for no longer than 15 minutes (with about 5 minutes for questions afterwards).

Action Items

Prior to your first day:

Review these Orientation materials on CANVAS.
If you anticipate any absences for interviews or other conflicts, please fill out an excused absence request form and email it to Angela Gangstad (agangstad@wisc.edu). If the absence is approved, you need to notify your nurse practitioner/NICU hospitalist/fellow/attending the week of the absence.

COVID

While you likely have PPE from other rotations that you have been on, if you do not, our team will help you obtain PPE on your first day of the rotation.

Where to go the first day

On the first day, you’ll meet in the NICU team room on the North side of the 8^th floor at AFCH at 8am (all other days the start time will be 7am). To get there from the UW Cafeteria, take the UW Atrium elevators to the 3^rdfloor. Take a left off of the elevators and walk across the skybridge towards AFCH. Once you cross the skybridge, you’ll go straight through a set of double-doors that requires badge access that you should have. (Of note, if your badge doesn’t work, you’ll have to walk around towards the AFCH lobby, meet at the Security desk and take the patient elevators to the 8^th floor). Walk through the double-doors and to your right will be the AFCH Staff elevators. Take these elevators to the 8^th floor. When you get off of the elevators, if you take a right you’ll head towards the North unit. Look for the arrows pointing towards “NICU Scrub Entry.” At this point, you’ll need to take off your coat and perform a surgical scrub up to your elbows (during your NICU month you will not be able to wear anything on your hands, wrists or lower arms…this means you cannot wear your white coat). After you scrub, you can badge through the “Scrub Entry” double doors and the NICU team room will be the 2^nd door on the left. Your team will be notified the week prior and will be expecting to see you. If you have any issues, please call the NICU front desk at 608-890-9600 and ask for one of the neonatal providers.

Notes/Rounding

We use medical student notes in the NICU. You will be expected to write daily progress notes on your patients and write an H&P for your admissions. We will provide you with our template to follow on your first day. Your notes should be shared with the NICU fellow when they are present, otherwise shared directly with the Neonatologist.
For the first day, you can see how we run rounds before picking up a patient that you’ll follow and present on daily.