One of the hardest parts about being a new NICU nurse was learning all of the lingo! There seems to be an abbreviation for everything. And if it isn’t an abbreviation, it’s certainly something that had never been in my vocabulary before. But don’t worry! I’ve compiled a list of some of the most common NICU terms and a quick and easy explanation of what each term means.
NICU Terms to Know
Adjusted Age/Corrected Age – The age of a baby based on their due date. So if a baby is 8 months old, but was born 3 months early, their adjusted age is 5 months. This is important when measuring development and milestones. The adjusted age is used for the first 2(ish) years of life.
Apnea – An unexplained pause/stop in breathing for > 20 seconds. There are three different types of apnea – central, obstructive, or mixed. Central apnea is unexplained and occurs when your body stops its effort to breathe. Obstructive apnea is when something is in the way of an infant breathing (i.e. soft tissue in the throat collapses and blocks the airway). This is important because apnea can lead to decreased heart rate and decreased oxygen saturation levels.
Art Stick/Arterial Stick – When you use an artery as a means to obtain blood. Usually used when you need a large volume of blood. The radial artery is most commonly used.
“Bag” – When an infant stops breathing (despite stimulation) and/or the heart rate drops below 60 you typically need to BAG. There are many different types of “bags”, but it typically has oxygen flowing to it and provides pressure. A bag should be readily available at every single bedside.
Bradycardia – A drop in heart rate.
Brain Bleed – Also known as intracranial hemorrhage, this is common in premature infants. A brain bleed can range from stage I-IV with IV being the worst. It’s also classified by right side, left side, or bilateral.
“Cares” – “Cares” or “hands-on” refers to when you touch the baby. When you change the diaper, check the temperature, auscultate. In the NICU this typically occurs every 3-4 hours and is a great time for parents to get involved in patient care.
Desats – When your baby has a “desat” event that means that its oxygen saturation levels drop. Every baby is individualized and each hospital has a different policy on what is an appropriate oxygenation level. To fix this you should make sure that the equipment that is being used is on and working. If it is, turn up the oxygen or reposition the infant.
Feeder-Grower – A feeder-grower is a baby who is medically stable and is just feeding (eating) and growing (gaining weight), preparing to go home.
Gavage – When a baby gavage feeds it means that they are getting milk from a tube that (typically) goes into their stomach.
Gestational Age – The age a baby is born at. This is measured in weeks and days. If you have a baby that was born at the age of 32 weeks and 3 days, you would say “GA 32 and 3”.
Heel Stick – A means to get blood. A small poke in the heel for small volumes of blood.
HIE – Stands for hypoxic-ischemic encephalopathy and is an emergency when a baby’s brain doesn’t get enough blood and oxygen.
Incubator – A temperature-controlled box that a baby is put in until they are big enough to transfer to an open crib. An incubator is usually used for premature babies. It can control temperature and humidity, plus acts as a sound and light barrier. Premature babies are started on “skin-mode” meaning the infant is not dressed and the temperature probe is placed on their skin to measure the temperature. The incubator air temperature adjusts to what the baby’s temperature is. Once the baby gets bigger, you switch to “air-mode” where you can dress the baby and the air temperature is changed by you (not the baby). When the baby gains enough weight and can maintain their own temperature they are placed in a crib. (Weights vary per hospital policy but the typical weight to come out of an incubator is around 1800 grams).
Intubated – When a breathing tube (an endotracheal tube or ETT) is placed down a baby’s trachea. This means that a machine – a ventilator – is breathing for the baby. There are different modes and different types of vents depending on why the baby is intubated.
IV – A small catheter that is placed in a vein and delivers antibiotics and nutrition or IV fluids. IV’s are for short-term use.
Kangaroo Care – When a baby is kept skin-to-skin on the chest of their mother or father. Typically the baby is naked and is placed right on the front of Mom or Dad’s naked chest. The skin keeps the baby warm and a blanket is placed over their back. If the baby is very premature a hat is usually also put on the baby’s head to ensure the baby doesn’t get cold. If a baby is doing skin-to-skin you want to make sure to check their temperature about every hour (or more if the baby is getting cold).
Lipids – Fat that is given to an infant to help with weight gain. It comes in a syringe or small bag and the fluid is white. This can be delivered through an IV, PICC, or UVC.
Micro-Preemie – A micro-preemie is a baby born before 26 weeks gestation.
NEC – Stands for necrotizing enterocolitis and is a common, sometimes fatal, condition in premature babies. This is an intestinal disease where the small or large intestine becomes inflamed and sometimes perforates.
ND – A nasoduodenal tube is a small tube that goes from the nares to the duodenum. It passes through the stomach and is typically placed in babies who experience frequent emesis. You need an x-ray for this to check placement and make sure that it’s in the right place.
NG – A nasogastric tube is a small tube that goes from the nares to the stomach. It’s used for babies who cannot eat by mouth. An x-ray is not necessary to confirm placement. Instead, you should aspirate or auscultate to confirm placement.
Non-Invasive Ventilation (NIMV) – Also known as CPAP (continuous positive airway pressure) or BiPAP (bi-phasic positive airway pressure), NIMV is non-invasive meaning that the baby is not intubated. The pressure comes from a mask or cannula that is placed on the infant’s nose.
NPO – NPO means that the baby cannot eat anything. This means that feeds are stopped whether this is by mouth or by a tube in the stomach. Instead, an IV is placed and nutrition is given through a vein. Reasons to go NPO are when a baby is firstborn, if a baby is getting surgery, or if a baby gets NEC.
OG – An orogastric tube is a small tube that goes from the mouth to the stomach for feeding purposes. It is not as good as using an NG tube because it usually comes out much more often but is placed when an infant is needing respiratory support through their nose in a form of a cannula, CPAP, or BiPAP. An OG is taken out and replaced with an NG when an infant starts to breastfeed or bottle-feed.
Open Crib – A crib that an infant is placed in when they can maintain their temperature and don’t need a heat source.
Pacing – A term used when feeding a baby. A baby that needs to be “paced” typically doesn’t have a coordinated suck-swallow-breathe meaning they are at risk for aspiration.
PICC – Stands for a peripherally inserted central catheter. A PICC line is for long term antibiotic or nutrition use. It has to be placed by someone who is specially trained as a “PICC nurse” or a nurse practitioner or doctor. This is a sterile procedure.
PO – PO means “by mouth”. If a baby is “PO feeding” it means that they are taking full or partial feeds by mouth whether that means using a bottle or breastfeeding.
Preemie – A birth that occurs before 37-weeks. Some hospitals now resuscitate babies as young as 22-weeks.
Primary Nurse – A nurse primarily has one patient. For instance, you can sign up to be a “primary nurse” on a baby and that means that every time you work you have that particular baby. This can be important because you know the baby better than anyone else and you get to know the family better than anyone else too.
Pulse Ox – A probe that is placed on a baby’s hand or foot that measures the oxygen level in the blood.
Radiant Warmer – An open bed that has a heat source. This is used for sick babies who aren’t premature and don’t need light and sound protection. Sometimes a baby is placed on a radiant warmer without the heat on because it’s easy to start IVs, etc because it doesn’t have crib rails.
ROP – ROP stands for retinopathy of prematurity and it’s an eye disease that occurs in premature babies that require a lot of oxygen supplementation. ROP is potentially blinding and starts being monitored > 30 weeks but there are different requirements in different hospitals.
Stim – Stim means stimulation and is when you have a baby that goes stops breathing or drops their heart rate and you rub their chest or back to get them to start breathing again or have their heart rate go up. This is common in premature and sick babies. If “stimming” the baby doesn’t work you need to resort to “bagging”.
Suck-Swallow-Breathe – A coordinated effort between sucking on a bottle, swallowing, and breathing that we monitor in premature babies learning how to eat. If a baby is not following all of these steps – sucking, swallowing, breathing – then there is a risk for aspiration. The way to help babies through this is by pacing them.
Tachycardia – Tachycardia is a fast heart rate. The more premature you are the higher the heart rate, but a fast heart rate can also be caused by sickness or heat amongst other things.
Tachypnea – Tachypnea is when you’re breathing fast. When a baby is tachypneic sometimes they require “support” – in the form of a nasal cannula. It’s important to watch how fast a baby is breathing because if they breathe > 70 breaths per minute it’s not safe for them to be eating by mouth.
TPN – TPN is total parenteral nutrition, and is what a baby receives in place of milk or when they are working up on feeds. TPN is given through an IV, PICC, or UVC.
UAC – An umbilical arterial catheter is placed by a physician or nurse practitioner and is threaded through the artery in the umbilical cord and is typically used to monitor blood pressure. This is placed on brand new infants with umbilical cords. Once the umbilical cord falls off you, you can’t place a UAC. You can also easily draw blood off of a UAC by a stopcock that is placed. This is beneficial because you don’t have to poke the baby as many times, but is not beneficial because every time you “break into the line” there is a risk of infection. UAC lines are placed for emergencies are taken out as soon as possible as to not cause an infection. Placing a UAC is a sterile procedure.
UVC – An umbilical venous catheter is placed by a physician or nurse practitioner and is threaded through a vein in the umbilical cord and is used for fluid management. This is placed on brand new infants with umbilical cords. Once the cord falls off, you can’t place a UVC. UVC’s are taken out as soon as possible as not to cause an infection. Placing a UVC is a sterile procedure.
Venous Stick – A means to get blood from a baby by sticking a needle in a vein. Typically, a hand vein or an AC vein is used.
When it comes to neonatal nursing, there are so many NICU terms to know. This list should be a good starting point into the world of the NICU. Remember, you can’t learn everything in one day. It’s okay and normal to feel overwhelmed. Just learn a little bit at a time and eventually, you will master the art of NICU nursing!
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