Neonatal Medicine

The aim of this module is to explore concepts fundamental to the neurological care of neonates.  You will study CSF circulation, the vulnerabilities of the preterm brain and specific differences between preterm and term brain injury. Important conditions to be covered include IVH, PVL and HIE. The causes of term brain injury will be explored including stroke, infection and hyperbilirubinemia.

The module will also focus on the causes and management of neonatal seizures. Throughout, a key aspect to be considered will be the long term consequences of brain injury and related clinical decisions, communicating these effectively to colleagues and parents.

The aim of this module is to explore concepts fundamental to the nutritional care of neonates.  You will study the nutritional requirements of neonates and discuss the benefits of breast milk. A comparison of different feeding methods and appropriate methods to increase feeds when the circumstances require it will be considered.

The pathophysiology, risk factors and diagnosis of Necrotising Enterocolitis (NEC) will be covered, alongside a study of prevention strategies, medical/surgical management and long-term complications of NEC.

Deciding when to transport a neonate or child and how to ensure the highest standards of safety and care whilst doing so are crucial issues for any healthcare system. The module will consider the benefits and justifications for centralised vs distributed organisation of health services.

The importance and nature of risk assessment in transport scenarios will be discussed, including the issue of speed versus safety.  Effective team working and communication, choice of appropriate personnel, the resources required for safe and effective transport and the effect on local services will also be considered.

This module aims to provide you with increased understanding and knowledge of the research process and statistics, to enable you to critically evaluate, synthesise and reflect on research evidence and incorporate this in to clinical practice. The focus will be on applying an evidence based approach to the neonatal setting but generalisable skills in research in a healthcare setting will be taught.

Assessment will involve a variety of methods including tests of knowledge and understanding, personal reflection on practice, contribution to case based discussions and written work.

On completion of the module a student should be able to:

1. Identify and reflect on different research methods (both qualitative and quantitative research), that are and can be used within critical care
2. Use this knowledge to evaluate literature critically and reflect on its implications for practice using appropriate methods for evaluating qualitative and quantitative research
3. Integrate statistical principles in analysing data; being able to delineate the appropriate methods to use for differing data sets
4. Demonstrate your research and statistical knowledge and skills, being able to identify appropriate research methods in order to address clinically meaningful questions
5. To use the knowledge on research, statistics and evidence based medicine, to reflect on and synthesise the research findings, to your clinical practice

The aim of this module is to explore concepts fundamental to the respiratory care of neonates.  You will study different lung volumes and capacities and the principles of ventilation.  The benefits of different forms of ventilation will be discussed in order to teach risk-benefit analysis and the justification of specific ventilation strategies, communicating these effectively to colleagues and parents. Steroid use and its consequences will be considered.  Medical conditions covered will include chronic lung disease and secondary pulmonary hypertension.

Assessment will involve a variety of methods including tests of knowledge and understanding, personal reflection on practice, contribution to case based discussions and written work.

On completion of the module a student should be able to:

1. Describe the anatomical and physiological development of the lungs throughout childhood.
2. Explain how similar insults and challenges to the respiratory system lead to different clinical presentations and pathologies as the child develops.
3. Analyse the risk-benefit for ventilatory support.
4. Develop and justify ventilatory strategies that reduce the short and long term consequences for respiratory and other systems.
5. Critically evaluate the long term consequences and management of respiratory support.
6. Articulate clearly the likely consequences of treatment in ways that will facilitate parental understanding and shared decision making.
7. Select, critically appraise and apply relevant research evidence.
8. Assess the complementary roles of different healthcare professionals and multi-disciplinary teams in the care of children.

Reflect upon your learning on the module and relate this to your individual clinical practice and experiences.

Specific challenges arise when care teams have to deal with situations involving the emergency treatment and critical care of neonates.  The module will teach the principles of resuscitation at birth and explore the different requirements of a preterm and a term infant.  By looking in detail at these requirements and the underlying physiology, it is intended that you will be able to develop and justify appropriate care strategies, communicating these effectively to colleagues and parents. Physiological adaptation at birth in regard to fluids and electrolytes and how to manage fluids and electrolytes in critical care situations will also be considered.

Deciding when to transport a neonate or child and how to ensure the highest standards of safety and care whilst doing it are crucial issues for any healthcare system. The importance and nature of risk assessment in transport scenarios will be discussed, including the issue of speed versus safety.  Effective team working and communication, choice of appropriate personnel, the resources required for safe and effective transport and the effect on local services will be considered.

Assessment will involve a variety of methods including tests of knowledge and understanding, personal reflection on practice, contribution to case based discussions and written work.

On completion of the module a student should be able to:

1. Describe the essential principles and specific challenges of resuscitation at birth.
2. Distinguish the different requirements of a preterm and a term infant.
3. Critically appraise the ethical dilemmas related to the resuscitation of an extreme pre-term neonate and sick term neonate.
4. Justify early ventilation strategies based on appropriate evidence.
5. Critically evaluate evidence and concepts relating to the ‘golden hour’ and the practical challenges arising for treatment and management.
6. Explain basic physiological adaptation at birth in regard to fluids and electrolytes
7. Justify approaches to fluid and electrolyte management in terms of the most likely clinical implications.
8. Articulate clearly the consequences of a child’s condition in ways that will facilitate parental understanding.
9. Select, critically appraise and apply relevant research evidence.
10. Assess the complementary roles of different healthcare professionals and multi-disciplinary teams in the care of children.
11. Assess the relative risks of transport versus local care of neonates and children.
12. Evaluate circumstances when speed of transfer is critical and explain how increased speed may compromise safety.
13. Determine how appropriate personnel are chosen for transport duties.
14. Anticipate factors contributing to effective communication and teamwork during transportation.
15. Discuss the practicalities and challenges of common clinical scenarios for transport.
16. Reflect upon your learning on the module and relate this to your individual clinical practice and experiences.