General Objectives

1. Obtain a broad understanding of the medical problems afflicting infants during the first month of life.
2. Acquire an understanding of, and appreciation for, prenatal care of high risk patients
3. Learn generally applicable principles in the NICU setting:
   1. physiology
   2. ethics
   3. reading, critiquing and applying the medical literature
   4. the use of the National Library of Medicine database to access medical literature

Specific Objectives

1. Be adept in neonatal resuscitation procedures and obtain AHA certification in neonatal resuscitation (NRP) by the end of the R-1 year. Get materials from attending during your first UW rotation (Newborn or NICU).
2. Accurately obtain a history of pregnancy and perinatal events relevant to the newborn and understand the unique aspects of the physical examinination of the premature and newly born full term infant, including gestational age determination and assessment and management of LGA and SGA infants
3. Understand the broad medical, social, and economic consequences of prematurity, including factors related to, or influencing, its incidence and the incidence of disorders unique to premature infants (e.g., lungs, eyes,).
4. Understand the broad medical, social, and economic consequences of congenital defects including factors related to, or influencing, its incidence
5. Be familiar with birth weight and gestational age-related neonatal morbidity and mortality statistics and comparisons of perinatal, neonatal and infant mortality rates, regionally, nationally and internationally
6. Be competent in the assessment and management of the infant in the delivery room with a backgrouund knowledge of transitional physiology (cardiopulmonary, metabolic and temperature changes).
7. Recognize the clinical presentation and provide appropriate management of emergencies presenting the first month of life including respiratory distress with/without cyanosis, shock, bleeding, or life threatening neurologic abnormalities.
8. Understand the physiology, pathophysiology, diagnosis, and treatment of acute and chronic respiratory disorders in the premature and full term infant, including hyaline membrane disease, apnea, meconium aspiration, persistent pulmonary hypertension, transient tachypnea, pneumonia, pneumothorax, pulmonary interstitial emphysema, diaphragmatic hernia, pleural effusions, congenital pulmonary disorders, and bronchopulmonary dysplasia.
9. Demonstrate knowledge of the clinical and laboratory diagnosis, pathophysiology, and treatment of the following disorders of premature and full term infants.
   1. Infection:
      1. Neonatal sepsis (bacterial, viral, fungal)
      2. Congenitally acquired infections (HIV, CMV, toxoplasmosis, syphillis, rubella)
      3. Localized infections (omphalitis, skin, osteomyelitis, arthritis, urinary tract )
      4. Understand the peculiarities of host defense mechanisms in the newborn.
   2. Hyperbilirubinemia (physiologic, hemolytic, obstructive)
   3. Metabolic disorders (hypoglycemia, infant of diabetic mother, hypo- and hypercalcemia, inborn errors of protein, organic acid and amino acid metabolism)
   4. Gastrointestinal disorders (necrotizing enterocolitis, bowel obstruction, gastrointestinal bleeding, abdominal wall defects).
   5. Cardiovascular disorders (presentation of congenital heart disease in the neonatal period, patent ductus arteriosus, congenital cardiomyopathies, hypertension).
   6. Hematologic disorders (neonatal coagulopathy, polycythemia, anemia).
   7. Renal disorders (acute renal failure, congenital malformation of the urogenital tract including agenesis, dysgenesis, cystic disease, obstructive uropathies, exstrophy of bladder).
   8. Endocrine disorders (congenital hypo- and hyperthyroidism, adreno-genital syndrome, ambiguous genitalia, hypoglycemia). See also Metabolic Disorders
   9. Thermoregulation
   10. Neurologic disorders (seizures, hydrocephalus, hypoxic-ischemic injury, neonatal asyphyxia, intraventricular hemorrhage and outcome)

Authors

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