We understand, NICU mamas—when you're tired and worried, some days just getting to the NICU is a major accomplishment. Then once you’re there, the mountain of newness can make your exhausted brain turn off, making it hard to absorb the information or training you need. Understanding technical words[1], the roles[2] of the many doctors, nurses, or technicians, and the functions of the strange machines can empower you, making you feel more confident.
Here’s a list of NICU terms to help you navigate through strange waters.
Who’s Who In the NICU & Beyond
A Baby's Nurse—a specially trained R.N. (registered nurse) who delivers nursing care to a baby. The R.N. works 12-hour shifts.
Attending Physician—a doctor who has the primary responsibility for coordinating the medical care for a patient. In the NICU this will generally be the neonatologist.
CCS (California Children's Services)—a state agency, operating by county, which assists with medical benefits and ongoing therapies for infants and children who meet certain diagnostic criteria.
Cardiologist—a medical doctor who specializes in the heart and circulation.
Case Manager—a staff member who interfaces with insurance agencies regarding medical necessity and length of stay, as required, helps with discharge planning, arranging for medical equipment and visiting nurses when necessary, and makes referrals to CCS for medically eligible infants. Many insurance companies also have CASE MANAGERS who are assigned to customize and individualize benefits for those with extensive or complex health care needs.
Charge Nurse—a nurse who is "in charge" of nursing care during a shift and assists doctors and parents in problem-solving and planning.
Clinical Nurse IV (CN IV)—a nurse who oversees and supervises the care given to each baby. There is usually one CN IV for each shift (day and night). CN IVs serve as the Charge Nurses. They can assist nurses, doctors and parents in problem solving and planning.
Consulting Physician (Cardiologist, Neurologist, Ophthalmologist, etc.)—a medical doctor trained in a medical area other than pediatrics.
Discharge Coordinator—a nurse who plans for discharge with the family and health care team when the baby goes home. She makes sure teaching has been completed and works with hospital staff and home health agencies. She also arranges for the parents to room-in and for home care, community services and Infant Progress Clinic.
Fellow (in Neonatology)—a trained pediatrician who is receiving additional specialized training in the care of sick newborns.
Gastroenterologist—a medical doctor who specializes in the digestive system.
House staff—a term referring to medical doctors who are enrolled in a supervised training program in an area of specialization, such as Pediatrics
Intern—a medical doctor in his or her first year of "residency." See also RESIDENT
IPC Coordinator—a nurse who helps plan developmental follow-up for some babies.
Neonatologist—a pediatrician who takes care of sick or premature newborns.
Neonatal Nurse Practitioner (NNP)—a registered nurse with master's degree training in neonatology. The NNP does exams and procedures under the supervision of the neonatologist.
Nephrologist—a medical doctor who specializes in disorders of the kidneys.
Neurologist—a medical doctor who specializes in the brain and nervous system.
Ophthalmologist—a medical doctor who specializes in disorders of the eye.
Parent Liaison (Parent-to-Parent Coordinator)—a member of the NICU team who has had her own infant in the NICU. She helps with parent-to-parent support programs.
Pediatrician—a medical doctor trained in pediatrics.
Primary Nurse Team—a team of nurses who plans the nursing care for a baby who is expected to be in the NICU a long time, and takes care of the baby.
Social Worker—a clinician with a master's degree who helps families with their feelings about having a tiny or sick baby. They also help with community resources and financial concerns.
Regional Center—one of a network of state-funded agencies which helps to coordinate community services and resources to infants at risk of having a developmental delay; also provides services and coordination of resources to children and adults with specific developmental disabilities.
Respiratory Therapist—a licensed person trained in managing breathing disorders, treatments, and procedures, oxygen and ventilators. Referred to as an RT or RCP (Respiratory Care Practitioner).
Occupational/Physical Therapist (OT/PT)—a person with special training in the growth and development of infants. She does exercises that help improve development and muscle control. This helps with feeding skills.
Otolaryngologist—a medical doctor who specializes in the ear, nose, and throat.
Technician (X-Ray, EEG, EKG, Ultrasound, etc.)—a person who performs specific tests ordered by the doctor.
Transport Coordinator—a nurse who oversees the entire neonatal transport program that brings sick babies from other hospitals into the NICU.
NICU Vocabulary
A's and B's—an abbreviation referring to episodes of apnea and bradycardia
Anemia—less than the normal number of red blood cells in the blood.
Apnea—the cessation of breathing.
Apnea monitor — a machine that sounds an alarm for NICU staff when a baby stops breathing for a few seconds
Arterial line — a thin tube that goes into a baby’s artery to check blood pressure and measure blood gases (acid, oxygen & carbon dioxide).
Asphyxia—a condition where there has been a lack of sufficient oxygen to the tissues of the body. The brain and the kidneys are the most sensitive organs to a lack of oxygen.
Aspiration—breathing a foreign material (such as formula, stomach fluids, meconium, etc.) into the lungs.
Bagging—filling the lungs with air or oxygen by squeezing a bag which is connected to an endotracheal tube or attached to a mask fitted over the face. This allows us to breathe for the baby when his own breaths are not enough.
Bililights —when a baby’s eyes and skin look yellow, they have jaundice because their liver isn’t fully developed or working well. Bright bililights are used over a baby’s incubator for 3-7 days to treat jaundice. Treatment with bililights is also called phototherapy.
Bilirubin—a breakdown product of red blood cells.
Blood Gases—the amounts of oxygen, carbon dioxide and degree of acidity in the blood. A small amount of blood is taken from the heel (by heel stick), umbilical catheter or from the artery near the wrist where a pulse is felt to test for these levels.
Blood Pressure (BP)—the pressure of the blood in the arteries with each pulsation of the heart.
Blood pressure monitor —a machine connected to a small blood pressure cuff wrapped around a baby’s arm or leg. The cuff takes a baby’s blood pressure at regular times and displays it on a screen.
Bradycardia—an abnormally slow heart rate.
Broviac—see CENTRAL CATHETER
Cardiopulmonary monitor — a machine connected to a baby’s chest with small sticky pads called leads that tracks a baby’s heart and breathing rates. If a baby’s heart or breathing rate becomes too fast or too slow, an alarm sounds.
CBC (Complete Blood Count)—a count of the various types of cells present in the blood, chiefly: red cells (for carrying oxygen), white cells (for fighting infection), and platelets (for prevention of bleeding).
CENTRAL CATHETER Or CENTRAL LINE—a thin, flexible tube (catheter) placed in a larger vein or artery to deliver medications or necessary fluids and nutrients to the body. Broviac catheters are usually placed in the upper chest and tunnel under the skin to enter the vena cava, the large blood vessel in the center of the body carrying blood to the heart. PICC lines (percutaneously inserted central catheters) are usually threaded through a vein in the arm to the vena cava. Central catheters also include umbilical venous and umbilical artery catheters which may be inserted into the vein or artery of the umbilical stump (belly button) shortly after birth.
Continuous positive airway pressure (also called CPAP) — a machine that sends air and oxygen to a baby’s lungs through small tubes in his nose or windpipe (also called trachea).
Chemstrip—a test in which a drop of the baby's blood is placed on a strip of special paper to determine the amount of sugar in the blood.
Chest Tube—a small plastic tube placed through the chest wall into the space between the lung and chest wall to remove air or fluid from this space.
Circumcision—a surgical procedure done to remove the foreskin of the penis. Usually done just before the baby goes home and only on request.
Congenital—existing at the time of birth.
Cooling blanket or cap — a blanket or cap used to lower a baby’s body temperature, and help reduce or prevent problems if a baby’s brain doesn’t get enough oxygen. A baby may get a cooling blanket or cap within about 6 hours of birth and can use it for up to 3 days. After that, a baby is slowly warmed to a normal body temperature of 98.6 F (37 C) by increasing the temperature in the incubator.
CPAP—Continuous Positive Airway Pressure - a form of ventilator assistance which helps to keep the baby's lungs properly expanded. CPAP does not breathe for the baby, but allows the baby to breathe into a "wind."
Ct Scan (of the head)—computerized x-rays which show the size and position of many parts of the brain. A CT scan also can be done on other parts of the body. The baby must go to another area of the hospital to have a CT scan.
Culture—a laboratory test of blood, spinal fluid, urine, or other specimens which shows if germs are present and which ones they are.
Cyanosis—blue color of the skin that occurs when there is not enough oxygen in the blood.
Differential—a test which divides the white blood cell count (from the CBC) into several categories, chiefly: "polys" (short for polymorphonuclear leukocytes), "bands" (immature "polys"), "lymphs" (lymphocytes), "monos" (monocytes), "cos" (eosinophils), "basos" (basophils). The percentages of each cell type may vary in different kinds of infections; for example, polys and bands usually will predominate in bacterial infections, while the number of lymphs usually will increase in viral infections.
Echocardiogram—a test done to look at the heart using sound waves through the chest wall. This is much like an ultrasound done during pregnancy and is neither harmful nor painful.
Edema—"puffy" skin from a build-up of fluid in body tissues.
Endotracheal tube — a small plastic tube attached to a machine called a mechanical ventilator to help you’re a baby breathe. It goes into a baby’s nose or mouth and down to the windpipe (also called trachea), sending air and oxygen to the lungs.
Exchange Transfusion—a treatment which removes the baby's blood in small quantities and replaces it with donor blood. This procedure is used most frequently to lower the level of bilirubin in the baby's blood. (See also Jaundice.) It also may be used to raise or lower the number of red blood cells, and improve the ability of the blood to clot.
Extracorporeal membrane oxygenation (also called ECMO) — a machine that takes blood out of a baby’s body, puts oxygen into the blood, then sends the blood back into the body.
Extubation—removal of a tube which has been placed through the nose or mouth into the trachea.
Gastrostomy—a surgically created opening in the abdominal wall to provide nutrition directly into the stomach.
Gastrostomy tube (also called g-tube or gastric feeding tube) — a tube that allows liquids to go into a baby’s stomach for feeding when they can’t take food by mouth and need long-term help with feeding.
Gavage Feedings—feedings delivered by a small plastic tube placed through the nose or mouth and down into the stomach when the baby is too weak or too premature to suck and swallow.
Genetics—the branch of medicine that deals with heredity, the variation of individuals, prognosis for development and function, and risks of recurrence of genetic conditions.
Heart Murmur (or “murmur”)—a rushing sound made by the blood within the heart, usually heard with a stethoscope. This may or may not be a sign of a problem for a baby.
Heelstick—a quick prick of the heel with a sterile instrument (much like a finger prick) to obtain small blood samples for tests.
Hematocrit (or “crit”)—a test done to determine if the amount of red blood cells in the blood is adequate.
High-frequency ventilator — a machine that breathes for a baby at a faster rate than other ventilators. Oscillating and jet ventilators are examples of high-frequency ventilators.
Humor, Sense Of—something you used to have before a baby was in the NICU. Don't lose your sense of humor—it helps parents get through these difficult times.
Hydrocephalus—an abnormal accumulation of cerebrospinal fluid (the normal fluid which bathes the brain and spinal cord) in the ventricles of the brain.
Hyperbilirubinemia—an elevated level of bilirubin in the blood.
Hypoglycemia—a low amount of sugar (glucose) in the blood.
I:E Ratio—the ratio of the length of the forced breath provided by a ventilator to the length of the time between two breaths.
Incubator —a clear plastic bed that helps keep a baby warm. You can touch a baby through holes (also called ports) in the sides of the incubator. Giraffe® and Isolette® are kinds of incubators.
Infiltrate (IV Inflitrate)—the slipping of an IV needle out of a vein, allowing IV fluid to accumulate in the surrounding tissues.
Intravenous line (also called IV) — a tube inserted with a needle into a baby’s vein. A baby can get fluids, medicine and blood through an IV.
Inspiratory Time (IT)—the length of a forced breath provided to the baby by a ventilator.
Intraventricular Hemorrhage (IVH)—a collection of blood in and around the ventricles (hollow portions) of the brain.
Intubation—placing an endotracheal tube in the baby's trachea (windpipe).
Jaundice—a yellow coloration of the skin and eyes caused by increased amounts of bilirubin in the blood. Bilirubin is a break-down product of red blood cells; it is processed and excreted by the liver. Treatments for jaundice include phototherapy ("bili-lights") and (rarely) exchange transfusion.
Lumbar Puncture ("Spinal Tap")—a procedure in which a small needle is placed in the small of the back, between the vertebrae (back bones), to obtain spinal fluid for bacterial cultures and other tests.
Mechanical ventilator — a machine that helps a baby breathe or breathes for them when their not breathing on their own. It works by pushing warm air and oxygen into the lungs through a breathing tube called an endotracheal tube.
Meconium—the first bowel movements that a baby has which are thick, sticky, and dark green to black in color.
Meconium Aspiration—the inhalation of meconium into the lungs. If a baby passes meconium before delivery, the meconium may be inhaled into the lungs, causing problems with breathing after the baby is born. This condition is called meconium aspiration syndrome (MAS).
Meningitis—infection of the fluid that cushions and surrounds the brain and spinal cord.
MRI (Magnetic Resonance Imaging)—a computerized method of viewing any portion of the body. It uses magnetism rather than x-rays. All metal must be removed from around the baby. The baby must go to another area of the hospital to have an MRI.
Nasal cannula — small plastic tubes that go into a baby’s nose. Air and oxygen go through the tubes into a baby’s lungs.
Nasogastric tube (also called NG tube) — a feeding tube that goes through a baby’s nose, down the esophagus and into the stomach. The esophagus is the tube in a baby’s body that carries food from the throat to the stomach. A baby can get breast milk, formula and medicine through the tube. When a baby is fed breast milk or formula though an NG tube, it’s called gavage feeding.
Necrotizing Enterocolitis (NEC)—an infection of the wall of the intestines, which may spread to the blood. Premature babies are particularly vulnerable to this disease. Surgery is sometimes necessary to remove damaged intestine, and the baby may need prolonged feeding by vein until he recovers.
Neonatology—the medical specialty concerned with diseases of newborn infants (neonates). Neonatologists are pediatricians who have received several years of additional training.
NPO—nothing to be given by mouth.
Orogastric tube (also called OG tube) — another feeding tube that goes in a baby’s mouth, down the esophagus and into the stomach. A baby can get breast milk, formula and medicine through an OG tube. When a baby is fed breast milk or formula though an OG tube, it’s called gavage feeding.
Oxygen hood (also called OXYHOOD or 02 hood)— a clear plastic box that fits over a baby’s head and gives him oxygen. Providers use it with babies who can breathe on their own but still need some extra oxygen.
Parenteral Nutrition (also called Total Parenteral Nutrition, or TPN)—protein and sometimes fats (lipids) given along with sugars and salts by vein when the baby cannot tolerate complete feedings by nipple or gavage.
Patent Ductus Arteriosus (PDA)—a small vessel which allows blood to bypass the lungs. This vessel is open while the baby is in the womb, but normally closes shortly after delivery. If the vessel fails to close on its own, special medication or surgery may be needed.
Peak Inspiratory Pressure (PIP)—the highest pressure that is delivered to the baby by the ventilator during a forced breath.
Phototherapy—a treatment in which the baby is placed under bright lights (frequently blue in color) or on a special light blanket which helps bilirubin to be excreted into the intestine.
PICC LINE—see CENTRAL CATHETER
PIP—see PEAK INSPIRATORY PRESSURE
PKU—a rare disorder in which one of the amino acids (a building block of protein) cannot be handled normally by the baby, leading to elevated levels in the blood. Babies with PKU require a special diet. All babies are routinely tested for PKU, as well as several other disorders, before going home from the nursery. This test is required by law.
Pneumomediastinum—leakage of air from the normal passageways of the lung into the space surrounding the heart inside the chest. A pneumomediastinum is usually harmless in itself, but is often associated with a pneumothorax (which can be life-threatening if large).
Pneumothorax—leakage of air from the normal passageways of the lung into the space surrounding the lung inside the chest wall, causing a partial or complete collapse of the lung.
Positive End-Expiratory Pressure (PEEP)—the lowest pressure that is delivered by the ventilator to the baby between forced breaths.
Prognosis—what is expected in the future.
Pulse oximeter (also called a pulse ox) — a small device wrapped around a baby’s foot or hand that measures the oxygen in their blood and helps providers know if this baby needs more or less oxygen. It doesn’t cause a baby any pain.
Radiant warmer — an open bed with overhead heating to help keep a baby warm. Providers may use a warmer instead of an incubator if a baby needs to be handled a lot.
Red Blood Cells—the cells in the blood which carry oxygen.
Reflux—a return or backward flow; gastroesophageal (GE) reflux occurs when portions of feedings or other stomach contents flow back up into the esophagus.
Respiratory Distress Syndrome (RDS)—a common breathing problem of premature infants caused by insufficient surfactant in the baby's lung. This results in an excessive stiffness of the baby's lungs.
Seizure—a "short circuiting" of the electrical activity in the brain, sometimes causing involuntary muscle activity or stiffening. There are many causes of seizures. If a child has a seizure, speak with a baby's doctor about this condition and its implications.
Sepsis—infection of the blood.
Septic Workup—an assortment of tests performed on an infant who is suspected of having an infection. This may include a chest x-ray and/or abdominal x-ray, as well as blood, urine, and spinal fluid cultures. Because infections in babies can progress very rapidly, the baby is frequently started on antibiotics until the results of the cultures are known.
Supra-Pubic Tap—obtaining an uncontaminated sample of urine by first cleaning off the lower abdomen, then inserting a needle directly into the urinary bladder.
Surfactant—a material secreted by special cells within the alveoli (air sacs) of the lung, which makes the lung flexible and helps to keep it from collapsing. Deficiency of surfactant is the main problem in Respiratory Distress Syndrome (RDS). Commercial products are available which can be put into the lungs through the tube in the windpipe. These products frequently are very helpful to the premature baby with RDS.
Tracheostomy tube — a curved plastic tube that goes in a baby’s windpipe (also called trachea) through a hole made in a baby’s neck. The trachea is part of the airway system that takes air to the lungs. A baby breathes through the tube instead of his nose and mouth. The tube doesn’t go into a baby’s lungs.
Transfusion—giving donated blood to the baby by vein or artery.
Ultrasound Of The Head—a test done using soundwaves which shows an image of the brain. The test is not harmful or painful to the baby and may be done at the bedside.
Umbilical catheter — a thin tube that goes into the arteries in a baby’s umbilical cord once the cord is cut after birth. Providers can give fluids, blood, medicine and nutrients—like vitamins and minerals—through the tube. They also use it to take blood from a baby. A small attachment to the tube lets providers check a baby’s blood pressure.
Urinary catheter — a thin tube that goes through the opening where urine passes out of a baby’s body and into his bladder. Providers use it to collect urine for testing.
[1] https://www.marchofdimes.org/complications/common-nicu-equipment.aspx
[2] http://www.goodbeginnings-csmc.org/neonatal/resources/terms.htm
