As a New NICU nurse I was so overwhelmed by the amount of medical "jargon" I needed to learn. (In addition to learning the best way to change a babies diaper...yes there is "the best way!") Here is a list of terms we use daily in the NICU setting & small (hopefully) helpful description of each.
While you are in the Neonatal Intensive Care Unit as a new nurse or parent you will hear the doctors & nurses speaking in what seems to be a foreign language. Understanding these words and adapting to this NICU culture can be quite a challenge. I have compiled a list of common terms here to help you in this process!
NICU Terms
A's & B's
an abbreviation referring to episodes of apnea and bradycardia; see APNEA and BRADYCARDIA.
ANEMIA
less than the normal number of red blood cells in the blood.
APNEA
The cessation of breathing <20 seconds
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.
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.
“BAGGING”
A slang term often used in the NICU meaning, to pump air into the baby’s lungs using oxygen and a rubber bag. This method is used temporarily to help a baby who needs help breathing.
"BLOW BY”
A slang term often used in the NICU meaning, to give a baby a small amount of oxygen through a tube pointed towards the nose.
BILIRUBIN
A yellow-pigmented waste product that forms when the body naturally eliminates old red blood cells. It may make the skin and eyes look yellow. In premature infants, they are often put under fluorescent light or on a bili blanket to help the levels come down.
BLOOD GAS
A blood test used to evaluate an infant’s level of oxygen, carbon dioxide, and acid. This helps to evaluate an infant’s respiratory status.
BRADYCARDIA (Brady)
A slowing of the baby’s heart rate.
BILILIGHTS (Phototherapy)
special lights used in the treatment of jaundice; see JAUNDICE.
BILIRUBIN
A breakdown product of red blood cells. See JAUNDICE.
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 your 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.
BRADYCARDIA
An abnormally slow heart rate.
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.
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).
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.
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.
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. See PNEUMOTHORAX.
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.:
CHRONOLOGICAL AGE
A baby’s age based on their actual birthday.
CORRECTED AGE
A baby’s age based on their gestation.
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 occurring 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 soundwaves 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 (ET Tube)
A plastic tube which goes from the baby's nose or mouth past the vocal cords and into the upper trachea (windpipe).
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.
EXTUBATION
removal of a tube which has been placed through the nose or mouth into the trachea; see ENDOTRACHEAL TUBE.
FELLOW (in Neonatology)
A trained pediatrician who is receiving additional specialized training in the care of sick newborns.
GAVAGE FEEDINGS (Tube Feedings or NG- Nasal Gastric Tube):
Providing nutrition through a plastic tube passed through the baby’s mouth or nose and 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
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 (crit)
A test done to determine if the amount of red blood cells in the blood is adequate.
HUMOR, SENSE OF
Something you used to have before your 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.
HEAD ULTRASOUND (HUS):
A painless test that uses sound waves to look at a baby’s brain. This test can be done at the bedside in the NICU.
"HEEL STICK”: A slang term often used in the NICU meaning, to obtain a blood sample by pricking the baby’s heel.
HIGH-FREQUENCY OSCILLATORY VENTILATOR
A special ventilator capable of breathing for a baby at rates exceeding those of a normal ventilator.
HYPOTENSION
Low blood pressure.
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.
INFILTRATE (IV Inflitrate)
the slipping of an IV needle out of a vein, allowing IV fluid to accumulate in the surrounding tissues.
INTRAVENOUS (IV) THERAPY
A small plastic tube or hollow metal needle placed into one of the baby's veins, through which fluids, sugar, and minerals can be given when the baby cannot take all of his nourishment by feedings.
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
Inserting a tube into the trachea (windpipe) through the nose or mouth to allow air to reach the lungs. See Endotracheal Tube.
"I's and O's”
A slang abbreviation often used in the NICU meaning, the amount of fluid, (IV and feeds) baby takes in compared to how much the baby pees and poops out.
ISOLETTE OR INCUBATOR:
A type of enclosed bed for an infant who is not mature or well enough to maintain her body temperature in an open crib.
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.
KANGAROO CARE
Skin-to-skin care where the baby is placed on the bare chest of the mother or father.
MECONIUM
The first bowel movements that a baby has which are thick, sticky, and dark green to black in color.
MECONIUM ASPIRATION MAS (Meconium Aspiration Syndrome)
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.
Monitor: A machine that displays the heart rate, respiratory rate, blood pressure and blood oxygen saturation of the baby.
NASAL CANNULA
A clear plastic tube which passes under the nose to provide supplemental oxygen.
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. See also PARENTERAL NUTRITION, SEPSIS.
NEONATOLOGY
The medical specialty concerned with diseases of newborn infants (neonates). Neonatologists are pediatricians who have received several years of additional training.
NEPHROLOGY
A medical doctor who specializes in disorders of the kidneys.
NEUROLOGIST
A medical doctor who specializes in the brain and nervous system.
NPO
Latin abbreviation for “nothing by mouth.” If the baby is kept NPO, all nutrition will be given intravenously.
OPHTHALMOLOGIST
A medical doctor who specializes in disorders of the eye.
OTOLARYNGOLOGIST
A medical doctor who specializes in the ear, nose, and throat.
PNEUMOTHORAX
A collapsed lung- the collection of air in the space around the lungs. This buildup of air puts pressure on the lung, so it cannot expand as much as it normally does when you take a breath.
PHOTOTHERAPY
Light therapy to treat jaundice. Bright blue fluorescent lights, called bililights, are placed over the baby’s incubator or the baby may be placed on a blanket that also shines the light up to the baby.
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.
PEDIATRICIAN
A medical doctor who specializes in infants and children.
PEEP
See POSITIVE END-EXPIRATORY PRESSURE.
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. See also BILIRUBIN, JAUNDICE.
PERIPHERALLY INSERTED CENTRAL CATHETER (PICC Line)
A PICC is a line inserted through a vein and then advanced through increasingly larger veins, toward the heart. Used when IV therapy, antibiotics, or nutrition (TPN/lipids) are administered for a long period of time.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.
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). See PNEUMOTHORAX.
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. See also PEAK INSPIRATORY PRESSURE (PIP).
PROGNOSIS
What is expected in the future.
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.
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.
RESIDENT (Pediatric)
A medical doctor who is training to become a Pediatrician. A residency program is usually three years long. First year residents are sometimes referred to as interns. Third year residents are sometimes called senior residents.
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. See also SURFACTANT
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 your child has a seizure, speak with your baby's doctor about this condition and its implications.
SEPSIS
A potentially fatal and dangerous condition in which the body is fighting a severe infection that has spread via the bloodstream. Infection of the blood. See also MENINGITIS, NECROTIZING ENTEROCOLITIS.
SEPTIC WORKUP
An assortment of tests is 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.
SPINAL TAP/LUMBAR PUNCTURE (LP)
A procedure in which a needle is inserted into the lower spine to obtain spinal fluid.
SUCTIONING
the process of removing secretions from the baby’s nose, mouth or lungs by using either a bulb syringe or suction catheter.
SURFACTANT
A material secreted by special cells within the alveoli (air sacs) of the lung, which makes the lung flexible and helps to keep the lung 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.
TACHYCARDIA: A fast heart rate.
TACHYPNEA: A fast breathing rate.
TRACHEOSTOMY
A surgical opening in the trachea, below the larynx (voice box) to allow air to enter the lungs; usually done to by-pass a narrowing in the area immediately below the larynx.
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 small plastic tube in one of the umbilical (belly button) blood vessels (either an artery or a vein).
WEAN
To take away gradually. In the NICU, it is often used to describe the process of removing an infant from a ventilator or incubator.
Learning your A, B, D’s (apnea, bradycardia, desats) will help you better understand your baby's journey through the NICU. You will soon, not only be accustomed to the lingo, but you too will be speaking this newfound language with ease.
HEAD OVER TO THE PODCAST!
Another great resource for you BELOW. I was featured on The Morning Rounds and talked all things NICU Nursing. Dynamics, my personal journey, NICU Nurse Tips & Tricks!
NICU Nurse Essential Resources
March of Dimes! Resources for parents & providers
Tori Meskin BSN RNC-NIC. Nurse. Blogger. Podcaster. Tori has been a clinician since 2012, works in acute care/inpatient NICU & Pediatric settings in southern California. She is a blogger, podcaster, NICU & Pediatric Critical Care RN, Sponsored Capella University MSN student, a Barco Uniforms Ambassador & Brave beginnings Ambassador. She has obtained her National NICU Nurse Certification (RNC-NIC) & has previously worked as a travel nurse, pursuing bedside experiences in several NICU settings. Follow her as she shares her NICU journey married life & juggles work, school, content creation, & brings you top notch Tips & Tricks along the way. Find her at www.tipsfromtori.com or info@tipsfromtori.com