Tests & Procedures
While your baby is in NICU/SCN they will likely undergo a large number of tests and procedures. Things can sometimes be fast paced and you may have a feeling of being overwhelmed with all that is happening. Writing things down may be helpful. You may also need to simply ask questions of the doctors and nurses, and continue asking until you fully understand. If they are not doing a good job of explaining ask if they have a diagram to show you, or if there is information in a book, or if you could speak to someone else who might explain differently. It is important for you to have a good grasp of what is happening with your baby.
This list is not exhaustive but provides some information on common tests and procedures carried out in NICU/SCN.
Antibiotics - Usually given intravenously to combat infection.
Blood gas - Baby's heel is pricked and a small amount of blood is collected in a very thin tube. The tube is then inserted into a machine which provides an accurate reading of the gas levels (oxygen, carbon dioxide, acidity & haemoglobin) in the blood.
Blood test - Blood is taken from a heel prick or a vein puncture and tested for a number of different things just like a regular blood test in an adult.
Blood transfusion - Normal blood volume at birth varies with gestational age. Some babies born prematurely and less than 1kg can have a blood volume of 80ml or less. Unfortunately it takes time for babies born to learn to make blood of their own, this process can also be hampered by illness. As blood is taken regularly for testing while baby is in NICU/SCN and they are unable to produce their own blood transfusions are often an appropriate treatment option.
ECHO (Echocardiogram) - Most babies admitted to NICU/SCN will have a routine ECHO, which is essentially an ultrasound of the heart, to check for any anomalies in the heart and surrounding major arteries. If an anomaly is detected baby will receive further ECHO's to monitor their condition and referral to a cardiologist may be appropriate if the anomaly is serious or does not resolve.
ECMO - ECMO stands for Extracorporeal Membrane Oxygenation which means that the blood receives oxygen outside of the body. It is used as a last resort when babies lungs are failing despite other treatments. ECMO takes over the work of the lungs allowing them time to rest and heal.
Eye examination - An opthalmologist will perform an eye exam to check for retinopathy of prematurity (ROP) in all at risk neonates in the NICU/SCN.
Heel prick - Baby's heel is pricked with a single use instrument to facilitate collection of blood for blood gas or full blood test.
Lumbar puncture - If your baby is unwell a sample of CSF (cerebrospinal fluid) may be collected for testing via a lumbar puncture. A needle is inserted into the lumbar area of babies spinal column to facilitate removal of the sample.
MRI (Magnetic Resonance Imaging) - If a head ultrasound has revealed a significant brain bleed and or lesions it may be appropriate for baby to have an MRI to gain a better understanding of the extent of their condition.
Hearing test - Babies requiring care in NICU/SCN are at increased risk of hearing loss than well babies so routine hearing screening is undertaken once baby is well. Small cups are placed over baby's ears, several small sticky probes are attached to baby's head each of these has a lead attaching it to a small machine. A series of very soft 'click' sounds are sent through the cups on the ears and baby's brain stem response is measured by the probes and a reading provided on the machine. This is a screening test only and if there is any abnormality baby will be referred on to an audiologist for more thorough testing.
Therapeutic hypothermia - Often used as part of the treatment for encephalopathy therapeutic hypothermia is where babies body is cooled to around 33C for a period of three days after birth in a effort to reduce brain damage and increase babies long term outcome.
Ultrasound - Most babies atmitted to NICU/SCN will have routine head ultrasounds to detect any bleeding or lesions in the brain. Ultrasounds may also be carried out on other parts of baby's body where there is concern over a particular organ.
X-ray - Chest x-rays are often taken in NICU to ensure correct placement of an ET tube. They can also pick up any issues with the heart and lungs. Occasionally further x-rays may be required in different areas of the body, e.g. if there is concern over a limb or where baby is having trouble feeding or passing stools.