The Six-Hour Window: How the Community Hospital Nursery Can Optimize Outcomes of the Infant with Suspected Hypoxic-Ischemic Encephalopathy

• Published in: Neonatal network Vol. 37; no. 3; p. 155
• Main Authors: Ibrani, Dafina, Molacavage, Shanon
• Format: Journal Article
• Language: English
• Published: United States 01.05.2018
• Subjects: Aftercare - methods; Asphyxia Neonatorum - complications; Asphyxia Neonatorum - physiopathology; Hospitals, Community - methods; Humans; Hypothermia, Induced - methods; Hypoxia-Ischemia, Brain - diagnosis; Hypoxia-Ischemia, Brain - etiology; Hypoxia-Ischemia, Brain - therapy; Infant, Newborn; Neonatal Nursing - methods; Nurseries, Hospital; Patient Transfer - methods; Resuscitation - methods; Risk Assessment - methods; Risk Management
• ISSN: 1539-2880
• DOI: 10.1891/0730-0832.37.3.155

Perinatal hypoxia is a devastating event before, during, or immediately after birth that deprives an infant's vital organs of oxygen. This injury at birth often requires a complex resuscitation and increases the newborn's risk of hypoxic-ischemic encephalopathy (HIE). The resuscitation team in a community hospital nursery may have less experience with complex resuscitation and post-resuscitation care of this infant than a NICU. This article provides the neonatal nurse in a Level I or Level II nursery with information about resuscitation and post-resuscitation care of an infant at risk of HIE while awaiting transport to a NICU for therapeutic cooling. The article describes the infant at risk for HIE, discusses pathophysiology and treatment of HIE, and lists essential components of post-resuscitation care while awaiting transport to an NICU, the importance of communication with the receiving NICU, and strategies for supporting the family.