Please note that our editors may make some formatting changes or correct spelling or grammatical errors, and may also contact you if any clarifications are needed. By the start of the second decade of the 21st century, it appeared likely that the EU would not develop capabilities competitive with those of NATO or even seek to do so; as a result, earlier worries associated with the spectre of rivalry between the two Brussels-based organizations dissipated. A neonatal intensive care unit NICU , also known as an intensive care nursery ICN , is an intensive care unit specializing in the care of ill or premature newborn infants. Care of the Newborn. Methicillin-resistant Staphylococcus aureus Oxygen toxicity Refeeding syndrome Ventilator-associated lung injury Ventilator-associated pneumonia Dialytrauma.
Besides prematurity and extreme low birth-weight, common diseases cared for in a NICU include perinatal asphyxia , major birth defects , sepsis , neonatal jaundice , and infant respiratory distress syndrome due to immaturity of the lungs. In general, the leading cause of death in NICUs is necrotizing enterocolitis. Complications of extreme prematurity may include intracranial hemorrhage , chronic bronchopulmonary dysplasia see Infant respiratory distress syndrome , or retinopathy of prematurity.
An infant may spend a day of observation in a NICU or may spend many months there. Neonatology and NICUs have greatly increased the survival of very low birth-weight and extremely premature infants. The NICU environment provides challenges as well as benefits. Stressors for the infants can include continual light, a high level of noise, separation from their mothers, reduced physical contact, painful procedures, and interference with the opportunity to breastfeed.
A NICU can be stressful for the staff as well. A special aspect of NICU stress for both parents and staff is that infants may survive, but with damage to the brain, lungs or eyes. NICU rotations are essential aspects of pediatric and obstetric residency programs, but NICU experience is encouraged by other specialty residencies, such as family practice , surgery , pharmacy , and emergency medicine.
An incubator or isolette  is an apparatus used to maintain environmental conditions suitable for a neonate newborn baby. It is used in preterm births or for some ill full-term babies. The blood pressure monitor is a machine that's connected to a small cuff which wrapped around the arm or leg of the patient.
This cuff automatically takes the blood pressure and displays the data for review by providers. This is used for babies who can still breathe but need some respiratory support. This is a breathing machine that delivers air to the lungs. Babies who are severely ill will receive this intervention. Typically, the ventilator takes the role of the lungs while treatment is administered to improve lung and circulatory function.
A transport incubator is an incubator in a transportable form, and is used when a sick or premature baby is moved, e. It usually has a miniature ventilator , cardio-respiratory monitor , IV pump , pulse oximeter , and oxygen supply built into its frame.
The concept of designations for hospital facilities that care for newborn infants according to the level of complexity of care provided was first proposed in the United States in India has 3-tier system based on weight and gestational age of neonate. Neonates weighing more than grams or having gestational maturity of 34 weeks or more are categorized under level I care. The care consists of basic care at birth, provision of warmth, maintaining asepsis and promotion of breastfeeding.
This type of care can be given at home, subcenter and primary health centre. Neonates weighing grams or having gestational maturity of 30—34 weeks are categorized under level II care and are looked after by trained nurses and pediatricians. The equipment and facilities used for this level of care include equipment for resuscitation, maintenance of thermoneutral environment, intravenous infusion, gavage feeding, phototherapy and exchange blood transfusion.
This type of care can be given at first referral units, district hospitals, teaching institutions and nursing homes. Neonates weighing less than grams or having gestational maturity of less than 30 weeks are categorized under level III care. The care is provided at apex institutions and regional perinatal centers equipped with centralized oxygen and suction facilities, servo-controlled incubators, vital signs monitors, transcutaneous monitors, ventilators, infusion pumps etc.
This type of care is provided by skilled nurses and neonatologists. The terminology used in the United Kingdom can be confusing, because different criteria are used to designate 'special' and 'intensive' neonatal care locally and nationally. These look after babies who need more care than healthy newborns but are relatively stable and mature. SCBU might provide tube-feeding, oxygen therapy , antibiotics to treat infection and phototherapy for jaundice.
In a SCBU, a nurse can be assigned up to four babies to care for. Also known as 'Local Neonatal Units', these can look after babies who need more advanced support such as parenteral nutrition and continuous positive airway pressure CPAP. Confusingly, they may also look after babies who need short-term intensive care such as mechanical ventilation. Babies who will need longer-term or more elaborate intensive care, for example extremely preterm infants, are usually transferred to a Level 3 unit.
Babies in a Level 2 unit may be classified for nursing purposes as 'Special Care', 'High Dependency' HDU in which a nurse will be assigned up to two babies or 'Intensive care' where nursing is one-to-one, or sometimes even two-to-one.
These look after the smallest, most premature and most unwell babies and often serve a large geographical region. Therapies such as prolonged mechanical ventilation, therapeutic hypothermia , neonatal surgery and inhaled nitric oxide are usually provided in Level 3 Units, although not every unit has access to all therapies..
The definition of a neonatal intensive-care unit NICU according to the National Center for Statistics is a "hospital facility or unit staffed and equipped to provide continuous mechanical ventilatory support for a newborn infant".
The four distinct levels of neonatal care defined in the most recent policy statement from the AAP are:. Level I units are typically referred to as the well baby nursery. Required provider types for well newborn nurseries include pediatricians , family physicians , nurse practitioners, and other advanced practice registered nurses.
Also, required provider types that must either be on site or at a closely related institution by prearranged consultative agreement include pediatric medical subspecialists, pediatric anesthesiologists, and pediatric ophthalmologists. Level IV units are required to have pediatric surgical subspecialists in addition to the care providers required for Level III units.
From Wikipedia, the free encyclopedia. Conceptualization and initiation of a neonatal intensive care nursery in PDF. National Institutes of Health. Baylor University Medical Center. Retrieved October 26, Global Unity for Neonatal Nurses. Council of International Neonatal Nurses. Nurses for a Healthier Tomorrow. Cadogan - An Essay upon Nursing - ". Archives of Disease in Childhood: Fetal and Neonatal Edition.
Pierre Budin - The Nursling". Respiratory distress syndrome and its management. Fanaroff and Martin eds. Diseases of the fetus and infant; 7th ed. Care of the Newborn. Expanded health data from the new birth certificate, Natl Vital Stat Rep. Levels of neonatal care. Elk Grove Village, IL. Health science Medicine Medical specialities Respiratory therapy. Methicillin-resistant Staphylococcus aureus Oxygen toxicity Refeeding syndrome Ventilator-associated lung injury Ventilator-associated pneumonia Dialytrauma.
Arterial blood gas Catheter Arterial line Central venous catheter Pulmonary artery catheter Blood cultures Screening cultures. Airway management Chest tube Dialysis Enteral feeding Goal-directed therapy Induced coma Mechanical ventilation Therapeutic hypothermia Total parenteral nutrition Tracheal intubation. Hemodynamics Hypotension Level of consciousness Acid—base imbalance Water-electrolyte imbalance.
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Further, wartime cooperation between the western Allies and the Soviets had completely broken down. Each side was organizing its own sector of occupied Germany, so that two German states would emerge, a democratic one in the west and a communist one in the east.
In the United States launched the Marshall Plan , which infused massive amounts of economic aid to the countries of western and southern Europe on the condition that they cooperate with each other and engage in joint planning to hasten their mutual recovery. It was soon recognized, however, that a more formidable alliance would be required to provide an adequate military counterweight to the Soviets. By this time Britain , Canada, and the United States had already engaged in secret exploratory talks on security arrangements that would serve as an alternative to the United Nations UN , which was becoming paralyzed by the rapidly emerging Cold War.
Spurred by the North Korean invasion of South Korea in June , the United States took steps to demonstrate that it would resist any Soviet military expansion or pressures in Europe. The North Atlantic Council, which was established soon after the treaty came into effect, is composed of ministerial representatives of the member states, who meet at least twice a year.
At other times the council, chaired by the NATO secretary-general, remains in permanent session at the ambassadorial level. The Military Committee, consisting of representatives of the military chiefs of staff of the member states, subsumes two strategic commands: NATO funding generally is not used for the procurement of military equipment, which is provided by the member states—though the NATO Airborne Early Warning Force, a fleet of radar-bearing aircraft designed to protect against a surprise low-flying attack, was funded jointly.
Beginning in , this policy was supplemented by the deployment of American nuclear weapons in western European bases. President Ronald Reagan in After , however, far-reaching economic and political reforms introduced by Soviet leader Mikhail Gorbachev fundamentally altered the status quo. In July Gorbachev announced that Moscow would no longer prop up communist governments in central and eastern Europe and thereby signaled his tacit acceptance of their replacement by freely elected and noncommunist administrations.
In keeping with the first objective, NATO established the North Atlantic Cooperation Council ; later replaced by the Euro-Atlantic Partnership Council to provide a forum for the exchange of views on political and security issues, as well as the Partnership for Peace PfP program to enhance European security and stability through joint military training exercises with NATO and non-NATO states, including the former Soviet republics and allies.
Special cooperative links were also set up with two PfP countries: Some observers argued that the alliance should be dissolved, noting that it was created to confront an enemy that no longer existed; others called for a broad expansion of NATO membership to include Russia. Most suggested alternative roles, including peacekeeping. By the start of the second decade of the 21st century, it appeared likely that the EU would not develop capabilities competitive with those of NATO or even seek to do so; as a result, earlier worries associated with the spectre of rivalry between the two Brussels-based organizations dissipated.
In the concurrent debate over enlargement, supporters of the initiative argued that NATO membership was the best way to begin the long process of integrating these states into regional political and economic institutions such as the EU.
Some also feared future Russian aggression and suggested that NATO membership would guarantee freedom and security for the newly democratic regimes. Opponents pointed to the enormous cost of modernizing the military forces of new members; they also argued that enlargement, which Russia would regard as a provocation, would hinder democracy in that country and enhance the influence of hard-liners.
Meanwhile, by the beginning of the 21st century, Russia and NATO had formed a strategic relationship. This bond was subsequently subject to fraying, however, in large part because of reasons associated with Russian domestic politics. Events following the September 11 terrorist attacks in led to the forging of a new dynamic within the alliance, one that increasingly favoured the military engagement of members outside Europe, initially with a mission against Taliban forces in Afghanistan beginning in the summer of and subsequently with air operations against the regime of Muammar al-Qaddafi in Libya in early Most observers regarded that scenario as unlikely, however.
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