Level 1 intensive care (maximal intensive care) | |
1. | Receiving assisted ventilation (including intermittent positive airway pressure, intermittent mandatory ventilation, and constant positive airway pressure) and in the first 24 hours after its withdrawal. |
2. | Of less than 27 weeks gestation for the first 48 hours after birth. |
3. | With a birth weight less than 1000 g in the first 48 hours after birth. |
4. | Requiring major emergency surgery for the preoperative period and postoperatively for 48 hours. |
5. | On the day of death. |
6. | Being transported by a team including medical and nursing staff. |
7. | Who are receiving peritoneal dialysis. |
8. | Who require exchange transfusion complicated by other disease processes. |
9. | With severe respiratory disease in the first 48 hours of life requiring fractional inspired oxygen concentration (Fio 2) of > 0.6. |
10. | With recurrent apnoea needing frequent intervention, for example over five stimulations in eight hours or resuscitation with intermittent positive pressure ventilation (IPPV) two or more times in 24 hours. |
11. | With significant requirements for circulatory support, for example inotropes, three or more infusions of colloid in 24 hours or infusions of prostaglandins. |
Level 2 intensive care (high dependency intensive care) | |
1. | Requiring total parenteral nutrition. |
2. | Having convulsions. |
3. | Being transported by a skilled neonatal nurse alone. |
4. | With arterial line or chest drain. |
5. | With respiratory disease in the first 48 hours of life needing Fio 2 of 0.4 to 0.6. |
6. | With recurrent apnoea requiring stimulation up to five times in an eight hour period or any resuscitation with IPPV. |
7. | Who require an exchange transfusion alone. |
8. | Who are more than 48 hours postoperative and require complex nursing procedures. |
9. | With a tracheostomy for the first two weeks. |
Special care | |
1. | Requiring continuous monitoring of respiration or heart rate by transcutaneous transducers. |
2. | Receiving added oxygen. |
3. | With tracheostomy after the first two weeks. |
4. | Being given intravenous glucose and electrolyte solutions. |
5. | Being tube fed. |
6. | Had minor surgery in the past 24 hours. |
7. | Receiving terminal care, but not on the day of death. |
8. | Being barrier nursed. |
9. | Undergoing phototherapy. |
10. | Receiving special monitoring (e.g. frequent glucose or bilirubin estimations). |
11. | Needing constant supervision (e.g. for babies of mothers who are drug abusers). |
12. | Being treated with antibiotics. |
Normal care | |
1. | Receiving care from the mother or mother substitute with medical or neonatal nursing advice if needed. |
BAPM/NNA, The British Association for Perinatal Medicine and The Neonatal Nurses Association.