Georgetown Week 6

This past week I was in the NICU. I didn't think I was going to like it, but the babies were so cute! The NICU here is a level 2. I think there are 4 levels, 1 being the most critical cases? I'm not sure.

When I was going over the module on Monday with the RD, she mentioned that she hadn't seen many cases of gastroschisis (a congenital malformation in which the abdomen remains open to the exterior; organs, usually the small intestine or part of the stomach is exposed and protruding outside of the body). But, one of the new babies had it! the abdomen was repaired immediately after birth, and the baby was doing fine. I also saw cases of meconium aspiration, PPHN, trisomy 21, and PDA.

I had a lot of practice with TPNs, even though most of it is calculated on the computer, as well as calculating feeds. Nutrition is very important in the NICU, and I realized that the MDs really rely on the dietitian for her expertise. We attended medical rounds most days and there were many cases when the RD had to suggest changes to the TPN - addition of acetate, lowering Na, K, etc. I felt like we focused on labs in the NICU a lot more than I did in other units. I was surprised by how much the MDs missed on the TPNs, some of the residents even forgot to review the TPN during rounds!

Overall, I enjoyed the NICU. I'm starting Peds tomorrow!