Emergency
The Neonatal Intensive Care Unit (NICU) at Lotus Children's Hospital is located in the Critical Care Complex on Level 1 of our building.
The unit is probably the best in India with regards to design, quality of construction, the underlying child safety measures : restricted access, designated sterile zones, uninterrupted power supply, medical gas distribution system and medical infrastructure. The NICU at Lotus is considered on par with some of the best NICU's in the world !
The NICU has three designated areas of care:
Neopods (Critical Care)
Newborns admitted into the Neopods are critically ill and require artificial life support technology. Typically, a very sick baby with life threatening illness / condition would be cared for here. The medical and nursing supervision and care is at the highest intensity here. Very premature babies, babies with serious infections, lung and heart conditions, and those with major birth defects involving the brain, heart, lungs and kidneys would be admitted here.
Medical support involves the use of highly sophisticated artificial breathing machines called 'ventilators' which are connected to the baby's windpipe through a special tube to provide 'lung support' to tide over the baby's crisis. These machines pump a mixture of oxygen and air at carefully set pressures to inflate the baby's lungs and in essence function as 'artificial lungs'. Many such newborns also require artificial heart and blood pressure support 'cardiovascular/homodynamic support' with medicines given continuously through veins with infusion pumps. The newborn's vital functions and other parameters are continually 'monitored' on a second to second basis using electronic devices called 'multi parameter monitors'. Sometimes the baby's blood pressure is directly measured with a tube inserted into an artery, and the values are displayed on the monitor.
Supportive care involves administration of intravenous fluids, antibiotics, blood and blood products and frequent testing of various bodily functions such as oxygen levels in the blood, blood salt levels (electrolytes), etc.
The Critical Care service for newborns at Lotus compares with the best in the world in terms of 'quality of care'. The equipment used, the level of expertise and training of the neonatologists and pediatricians and nurses in our NICU is comparable to any center of excellence in the developed countries.
There are other highlights of our NICU which are unique and available in very few centers in India and the developed world. The first feature is the availability of “High Frequency Oscillators”, This is one of the most sophisticated types of ventilators (artificial breathing machines) which delivers breaths to the baby at the rate of around 400 - 600 breaths per minute as compared to 40 - 60 breaths given by a conventional ventilator. This high frequency oscillator is very helpful in treating the premature babies whose lungs have not matured as well as in all babies suffering from severe forms of respiratory failure (lung failure) due to any cause. These oscillatory ventilators, imported from the United Kingdom, require a high degree of expertise to operate. Our hospital takes pride in being one of the earliest centers to use this type of ventilator in the country and probably is one of the reasons of our high success rate in treating premature babies and babies with life threatening forms of lung failure.
The second feature is the availability of a special type of gas to use along with the high frequency oscillators. This medical gas is called “Nitric Oxide”. This gas has specific uses in the NICU in babies suffering from high blood pressure in their lungs, in medical parlance known as 'pulmonary hypertension'. Combined with the High Frequency Oscillators, inhaled nitric oxide delivered through a special delivery system into the baby's lungs helps relax the blood vessels in the lungs, thereby improving oxygen uptake. Inhaled Nitric Oxide treatment is available in very few centers in India and Lotus Children's Hospital is the first center to use successfully Inhaled Nitric Oxide with High Frequency Oscillatory ventilation ! Our team of neonatologists and pediatricians have special training in its use.
The third and foremost feature of our unit is the high nurse to babies ratio and strict isolation of babies into the different Neopods. Only three babies are accommodated in one Neopod and there are 3 exclusive newborn nurses available in each Neopod. All the nurses are highly trained as far as the control of infection is concerned and this decreases the chances of cross infection in critical care unit which is a problem most of the neonatal centers across the country are grappling with everyday. Our unit takes pride in having a very minimal level of cross infection.
Neonatal High Dependency Unit
Once babies are off life support and recovering from illness, or problems related to pre maturity, they are transferred to the High Dependency Unit where they are nursed and monitored continually. Such babies are typically off oxygen or breathing support and still on artificial tube feeding and on intravenous fluids and antibiotics. Many prematurely born and very low birth weight babies (less than 1500 grams at birth) are cared for in this unit in special incubators which have a carefully controlled internal temperature and humidity. They may need to stay for several weeks till they are mature enough to feed from their mothers and maintain their body temperature.
Neonatal Nursery
Newborns admitted for minor problems or those who need a brief period of observation or those who are being readied for discharge home are cared for in the nursery.
Feeding Room for Mothers and Total Parenteral Nutrition Service
We have a special room for mothers to come to the NICU to breast feed their babies in total privacy under the supervision and guidance of trained newborn nurses. The Total Parenteral Nutrition Service is provided for those newborns who cannot be fed milk and require special fluids to be administered through veins. The special fluids consisting of glucose, water, electrolytes and other nutrients are prepared under a special sterile ' Laminar Flow System' with an absolutely sterile technique. Trained pediatricians and nurses prepare these fluids under guidance from senior consultant neonatologists.
Nursing care
The prime reason for successful outcome of virtually all critically ill babies in our NICU is the excellent work and support of our newborn nursing staff. All the nurses posted in the NICU are highly trained and undergo regular in-house training and refresher programmes which include Neonatal Advanced Life Support [NALS course] and Neonatal Resuscitation.
Parent Counseling Room:
One of the highlights of our Neonatal Intensive Care Unit is the regular and detailed counseling of the parents and family of all children admitted in the NICU. On a daily basis, at a scheduled time, the Neonatologists (Newborn Specialist doctors) meet with the parents in a special counseling room and explain the medical condition of their baby in simple layman's terms. Information is given about the current working or confirmed diagnosis of the baby, along with the current medical condition, including the status of function of various vital organ systems, the results of tests from the previous day, and the plan of management: both immediate and long term in simple terms which parents can understand. This personalized attention and time given by our consultants regularly allays the fears the parents they have about their baby, clarify all doubts and questions and allows them to ask questions to fully understand their baby's illness and the stage of illness. Any surgical procedures, invasive procedures are also explained sometimes with the help of simple diagrams and informed written consent obtained as and when necessary by our consultants and pediatricians.
Viewing Gallery
We at Lotus understand the emotions of parents and the family when their child / children are admitted in our ICU's. We also believe in involving the parents and family in the care of their newborns and children. To enable the family to see their child at very close quarters, without entering highly sterile patient care zones, we have provided an extensive viewing gallery all around the NICU. What is more unique is the provision of a two way communication phone system which nurses and the family can use across the glass barrier to communicate!
This is probably the ONLY children's hospital in India to provide virtually close quarters access for parents and family to directly view their sick child and talk to the medical and nursing staff inside the ICU's.
Emergency Neonatal Transport System
Lotus Children's Hospital has specially designed ambulances to transfer sick newborn babies from other hospitals, nursing homes and health centers not only from the twin city area, but from a distance of of up to 300 kms. These vehicles are fitted with artificial life support gadgets and carry sufficient oxygen and have all necessary equipment to care for sick newborns while en route to our hospital.
A unique feature of our NICU is that we have state-of-the-art transport incubators fitted with sophisticated life support gadgets, monitoring devices and oxygen to safely transfer a critically ill baby on artificial life support from another hospital or center. Such advanced newborn transport systems are not available in most other children's hospitals.
The transport system can be accessed using our emergency contact numbers.
We have a dedicated and specialized neonatal (newborn) transport team consisting of a pediatrician trained in pediatric and newborn emergency medicine and an intensive care unit nurse who is well trained to tackle any emergency during transport. There is a transport team always on standby and can be dispatched at a very short notice to retrieve a sick newborn baby from any hospital within the twin cities area and from within a radius of 300 kms of the hospital!
The Newborn (Neonatal) Medical Team
- Dr VSV Prasad, MD Peds (AIIMS,New Delhi), AB Peds (USA)
Senior Consultant Neonatologist & Pediatric Intensivist - Dr Manoj Malviya, MBBS, DCH, MRCP Peds (London, UK)
Fellowship - Neonatology (Canada), Fellowship - Neonatology (Australia)
Senior Consultant Neonatologist - Dr KVAR Neelima, MD Peds
Consultant Pediatrician & Intensivist - Designated Pediatric Registrars (Junior Pediatricians)