Table 1

Classification of dependency level using the BAPM/NNA system

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.