The Six-Hour Window: How the Community Hospital Nursery Can Optimize Outcomes of the Infant with Suspected Hypoxic-Ischemic Encephalopathy

Abstract

Perinatal hypoxia is a devastating event before, during, or immediately after birth that deprives an infant’s vital organs of oxygen. This injury at birth often requires a complex resuscitation and increases the newborn’s risk of hypoxic-ischemic encephalopathy (HIE). The resuscitation team in a community hospital nursery may have less experience with complex resuscitation and post-resuscitation care of this infant than a NICU. This article provides the neonatal nurse in a Level I or Level II nursery with information about resuscitation and post-resuscitation care of an infant at risk of HIE while awaiting transport to a NICU for therapeutic cooling. The article describes the infant at risk for HIE, discusses pathophysiology and treatment of HIE, and lists essential components of post-resuscitation care while awaiting transport to an NICU, the importance of communication with the receiving NICU, and strategies for supporting the family.