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Delivery - attendance by paediatric staff at delivery

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Paediatric resident medical staff and NS-ANP's are available to attend at risk deliveries and compromised fetuses. Referrals should be made by the LMC attending the mother. In emergencies or situations of urgency, messages can be relayed through clerical staff. Paediatric staff often have to prioritise calls, so accurate information is needed. 

In most situations the 1st call locator (usually a paediatric SHO, registrar, or NS-ANP) should be called. Except in the situations set out below when 2nd call registrar or NS-ANP should attend, the 1st call person is responsible for informing other paediatric staff if he/she wants them to attend as well. The registrar/NS-ANP will attend deliveries with a house surgeon at the beginning of a run, until the house surgeon is competent at resuscitation.

The paediatric registrar/NS-ANP will contact the specialist if his/her presence is indicated, unless there is a prior arrangement.

The paediatric service should be informed of women in labour if the baby is likely to require care from the Newborn Service. Communication would normally be to the Neonatal Paediatric Medical team regarding clinical information. Bed status should be checked with the Clinical Charge Nurse. Referrals requesting neonatal paediatric input to the management of pregnancy/labour should be to specialists.

  1st Call Registrar-NS
-ANP-SHO Locator

93 5537 or
021 852 598
or 29598
Level 2 Registrar-NS-ANP
Locator

93 5536 or
021 891 404
or 29283
Level 3 Registrar-NS-
ANP Locator

93 5535 or
021 891 409
or 29361
Specialist
Meconium staining
light, no fetal distress
 No      
Light + fetal distress  Yes      
Thick  Yes      
Fetal distress  Yes  If severe    
Preterm 35-36 weeks   Yes      
Preterm 32-34+6 weeks       Yes    
Preterm < 32 weeks      Yes Discuss prior to labour/delivery 
Term IUGR  Post delivery       
Term Severe IUGR (<2.2kg)     Yes    
Suspected fetal infection  Yes      
Term Multiple pregnancy    Yes    
LSCS (Elective low risk
with regional anaesthetic)  
No       
Urgent or Category 1 LSCS    Yes    
Low forceps     No      
High forceps   Yes      
Low ventouse delivery, no fetal concerns     No      
Ventouse delivery with fetal distress,
meconium, or obstetric concerns 
 
 Yes      
Vaginal Breech delivery   Yes      
Maternal Substance Use  Post delivery       
Fetal abnormality likely to affect condition at delivery        Discuss prior to labour/delivery
Fetal abnormality other than above       Discuss prior to labour/delivery
Haemolytic disease         Discuss prior to labour/delivery

All three resident paediatric staff answer 777 emergency calls. The 777 call does not go to the specialist on call - a request for specialist attendance will need to be directed through the operator. If a specialist is required urgently, then contact them via their mobile phone. 

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Document Control

  • Date last published: 31 May 2016
  • Document type: Clinical Guideline
  • Services responsible: Neonatology
  • Owner: Newborn Services Clinical Practice Committee
  • Editor: Sarah Bellhouse
  • Review frequency: 2 years