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Additional resources for Avery’s Neonatology: Pathophysiology and Management of the Newborn
6 Definitions, Capabilities, and Provider Types: Neonatal Levels of Care Level of Care Capabilities Level I Provide neonatal resuscitation at every delivery Well newborn nursery Evaluate and provide postnatal care to stable term newborn infants Stabilize and provide care for infants born 35-37 wk of gestation who remain physiologically stable Stabilize newborn infants who are ill and those born at <35 wk of gestation until transfer to a higher level of care Level II Special care nursery Level III Level I capabilities plus: Provide care for infants born ≥32 wk of gestation and weighing ≥1,500 g who have physiologic immaturity or who are moderately ill with problems that are expected to resolve rapidly and are not anticipated to need subspecialty services on an urgent basis Provide care for infants convalescing after intensive care Provide mechanical ventilation for brief duration (<24 h) or continuous positive airway pressure or both Stabilize infants born before 32 wk of gestation and weighing <1,500 g until transfer to a neonatal intensive care facility Level II capabilities plus: Provider Typesa Pediatricians, family physicians, nurse practitioners, and other advanced practice registered nurses Level I health care providers plus: Pediatric hospitalists, neonatologist, and neonatal nurse practitioners Level II health care providers plus: NICU Provide sustained life support Pediatric medical subspecialists,b pediatric anesthesiologists,b pediatric surgeons, and pediatric opthalmologistsb Provide comprehensive care for infants born <32 wk of gestation and weighing <1,500 g and infants born at all gestational ages and birth weights with critical illness Provide prompt and readily available access to a full range of pediatric medical subspecialists, pediatric surgical specialists, pediatric anesthesiologists, and pediatric ophthalmologists Provide a full range of respiratory support that may include conventional and/or high-frequency ventilation and inhaled nitric oxide Perform advanced imaging, with interpretation on an urgent basis, including computed tomography, MRI, and echocardiography Level IV Regional NICU aIncludes all bAt Level III capabilities plus: Located within an institution with the capability to provide surgical repair of complex congenital or acquired conditions Maintain a full range of pediatric medical subspecialists, pediatric surgical subspecialists, and pediatric anesthesiologists at the site Facilitate transport and provide outreach education Level III health care providers plus: Pediatric surgical subspecialists providers with relevant experience, training, and demonstrated competence.
Department of Health and Human Services, Health Resources and Services Administration, Maternal and Child Health Bureau. Child health USA 2013. S. Department of Health and Human Services, 2013. 4 Postneonatal mortality is most often attributed to SIDS, other sleep-related deaths, congenital malformations, and unintentional injuries. Once again, there are notable racial and ethnic disparities. 93) (2). Perinatal mortality is another important measure of pregnancy health and takes into account fetal deaths as well as early (first week of life) neonatal deaths.
4 Postneonatal mortality is most often attributed to SIDS, other sleep-related deaths, congenital malformations, and unintentional injuries. Once again, there are notable racial and ethnic disparities. 93) (2). Perinatal mortality is another important measure of pregnancy health and takes into account fetal deaths as well as early (first week of life) neonatal deaths. There are an estimated 1 million fetal deaths reported annually in the United States (8). Most fetal deaths are caused by chronic asphyxia, congenital malformations, and pregnancy complications, such as placental abruption, diabetes mellitus, and intrauterine infections (10).