NICU Admission Criteria for Outpatients
Very few outpatients who are less than 2 weeks of age are appropriate for admission to the NICU because of their infectious risk and/or because most do not require intensive care.
To be considered for admission to the NICU as an Outpatient you must:
1. Be 14 days old or less.
2. Require intensive care.
Exclusion Criteria:
1. Gastroenteritis or diarrhea.
2. Fever or likely viral infection
3. Possible RSV or likely viral respiratory infection.
Possible exceptions
It is doubtful there are ever exceptions to the exclusion criteria of gastroenteritis, respiratory infection or age (i.e., admitting an infant greater than 2 weeks old); the infection risks from these patients pose too great a threat to other NICU patients. There may be exceptions to the criterion of requiring intensive care in certain circumstances to be determined by an attending Neonatologist.
An exception would mean that either this patient is well known to the NICU and is best served by returning there or the Neonatologist feels the NICU is the most appropriate place to manage this patient. For that reason an attending or on call Neonatologist would have to determine if the admission is appropriate.
Possible exceptions include:
1. A previously discharged NICU patient who has been home for only a few days. In general, an NICU discharge whose age is greater than 14 days from birth is best served by readmission to the general floor or the PICU if they need intensive care.
2. Hyperbilirubinemia if: the level is excessively high or there is significant hemolysis and there is a chance that an exchange transfusion would be needed; or it is a failure of breast-feeding and a Lactation Consultant will need to be involved. Most hyperbilirubinemia patients should go to the general floor.
3. Some neonatal apnea patients. Most apnea patients should go to the general floor. Many of these patients have RSV or other viral infections and therefore wouldn’t be admitted to the NICU for that reason.
4. Unexpected apnea or a need for mechanical ventilation in a post-op neonate. These patients are not technically outpatients since they have been admitted for surgery and do not pose a significant risk because they had appropriate screening to be eligible for surgery.
21 September 2009