Surgical Management
Before surgery, parents should ideally meet and sign consents with these two specialists—preferably the day before surgery.
Who are the surgeon and the anesthesiologist?
Nurses may perform central venous line dressing changes only after completing this requirement.
What is competency validation?
This documentation step must occur before releasing a blood product order, ensuring parents or guardians understand transfusion risks and benefits.
What is consent?
During umbilical catheter insertion, the nurse is empowered to halt the procedure if this critical standard is broken.
What is sterile technique?
Most newborns not requiring immediate resuscitation should undergo this practice for at least 60 seconds, a change emphasized in the 9th Edition.
What is deferred (delayed) cord clamping?
If a PICC is the only line available, staff should attempt to start this type of IV access for anesthesia use.
What is a peripheral IV (PIV)?
This is never done to central line dressings, even if they appear loose or lifting.
What is reinforcing the dressing?
According to the protocol, blood products may NOT be administered through a UAC, CVL, or PICC — but this umbilical line may be used with provider order.
What is the Umbilical Venous Catheter (UVC)?
Every umbilical line placement must be followed by this imaging test, unless the physician orders otherwise.
What is an X‑ray?
Effective neonatal resuscitation prioritizes this step above all others, as indicated by an increasing heart rate.
What is effective ventilation?
When the OR calls for the patient, the infant must be placed into this pre‑warmed transport environment and connected to monitoring.
What is a warmed transport isolette/Cavitron?
During skin prep for infants less than 28 weeks' gestation, povidone‑iodine must be allowed to air‑dry for this minimum amount of time.
What is 2 minutes?
During the initial phase of transfusion, the nurse must stay at the bedside for this duration to monitor for an adverse reaction.
What are the first 15 minutes?
After removing a UAC or UVC, continuous pressure must be applied for at least this length of time before observation begins.
What is 5 minutes?
For newborns requiring respiratory support, initial oxygen concentration should remain at 21% for those at or above this gestational age.
What is 35 weeks?
For postoperative vital signs after general anesthesia, these are the first three required intervals.
What are every 15 minutes ×4, then every 30 minutes ×2, then every hour ×2?
After chlorhexidine skin prep for older gestational ages, this minimum air‑dry time is required before dressing application.
What is 30 seconds?
This requirement ensures a safe infusion setup: if a blood bag arrives without an attached syringe, the nurse must do this before drawing it up.
What is filter the blood product while drawing it into a syringe?
Umbilical line stopcocks and claves must be changed at this interval, using sterile technique during routine tubing changes.
What is every 96 hours?
In the 9th Edition, these corrective ventilation steps (formerly sequential) are now described as flexible rather than rigidly ordered.
What is MR SOPA?
If an infant has had multiple intubation attempts previously, the decision about where to intubate before surgery must be made collaboratively between these two providers.
Who are the neonatologist and the anesthesiologist?
To maintain patency in all central venous line (CVL) fluids, this additive must be included at 0.5–1 unit per milliliter.
What is heparin?
This is the frequency at which vital signs must be monitored after the initial 15‑minute check, continuing for the remainder of the transfusion.
What is every 30 minutes?
Umbilical line care is performed at this interval and includes cleansing with Betadine, letting it dry, cleaning with sterile water gauze and assessing for redness or discharge.
What is every 6 hours?
In the 9th Edition, the recommended initial Peak Inflation Pressure (PIP) for newborns ≥32 weeks has been increased to this value.
What is 25