Potential Indications of NICU Admission

Guidelines for Admission to Level 3

• Birthweight less than 1,250g
• Gestation less than 30 weeks
• Some infants born at 30-32 weeks may be admitted to Level 3 because of staffing acuity
• Infants requiring mechanical ventilation or Continuous Positive Airway Pressure
• Requirement for an exchange transfusion
• Any other baby whose clinical condition is such that they cannot be appropriately cared for in Level 2
• Infants with any surgical indications, which will be transferred to a surgical unit

Guidelines for Admission to Level 2

• Low birthweight - under 2500g. Some babies between 2000-2500g may be able to go directly to the postnatal ward. This will depend upon the clinical assessment of the baby and whether the postnatal ward is deemed likely to provide an appropriate level of care or not.
• Prematurity - 35-36 weeks’ gestation or less.
• CNS problems  - Convulsion, moderate birth asphyxia, which may require monitoring for an initial period to ensure problems do not ensue.
• Respiratory problems - Apnea or cyanotic episodes, respiratory distress causing concern, persisting signs of respiratory distress for more than one hour, infants who received positive pressure ventilation.
• Cardiovascular - Problems requiring monitoring or intervention unavailable on the postnatal wards, infants who received chest compression even for a brief period.
• Gastrointestinal problems - Feeding problems severe enough to cause clinical concern, bile stained vomiting, or other signs suggesting bowel obstruction.
• Infection - Suspicion of infection together with clinical concern.
• Metabolic problems - Inability to maintain a serum glucose concentration greater than or equal to 2.6mmol/L (47mg/dL) despite adequate feeding.
• Malformations - Congenital anomalies that may require intervention unavailable on the postnatal wards, or an initial period of observation.
• Miscellaneous - Any baby that is causing concern to such a degree that the baby requires observation or treatment in NICU.
• Social Issues/Terminal Care - Such babies ideally be nursed on the ward with parents or at home. However, on some occasions these babies require a period of care on NICU.