The state designated Regional Perinatal Center (Level III) is based at UMass Memorial Health Care, the Perinatal Unit for the University of Massachusetts Medical School. There are 9,700 deliveries in Central Massachusetts with 3,800 occurring at UMass Memorial Health Care. This includes over 250 maternal transports. The new NICU (on the fifth floor) opened in June, 1996 and consists of 27 NICU/IICU; 16 CCN and 42 well-baby beds. There are around 500-550 NICU admissions of which 125 are neonatal transports. Over 53 percent of the admissions are under 2500 grams and 20 percent under 1500 grams. One-third of the admissions require mechanical respiratory support. This population is adequate for clinical research studies.
A new OB Obstetrical Unit is located on the 4th floor of the new East Wing at Memorial Health Care and consists of four LDRs, 42 LDRP rooms, three delivery rooms, one recovery room, and two normal newborn nurseries. An antepartum testing and ultrasound area and diagnostic U/S are located in the high risk clinic area. An antepartum high-risk floor is located on South 4, adjacent to the 4th floor Obstetrical floor (East Wing). Almost 100 percent of deliveries are monitored externally or internally. OCT's are done in the labor and delivery area or antepartum high-risk area and NST in the antepartum testing area. Biophysical profiles are done in either area. Scalp pH and fetal ultrasound are available 24 hours per day. All high risk, problem deliveries and cesarean sections are designated on a board in the NICU area. The resuscitation team (neonatal fellow, pediatric resident, NNPs, attending neonatologist, nurse and respiratory therapist) is called for all these deliveries. Warmers, resuscitation boards, oxygen blenders, ventilation equipment and catheter equipment is available in all delivery areas. Cord pH/BE is done on many deliveries especially high risk. Anesthesia is available 24 hours per day in-house including an OB anesthesiologist. A cord blood donor bank program started in 1996 (one of four in the country) on a voluntary basis.
The NICU is equipped with modern monitoring equipment including RR, HR, BP, CVP, TcO2 (10 Hewlett-Packard) , TcCO2 (10 Hewlett-Packard), ET CO2 (Novametrix 7100), O2 saturation monitors (29 Hewlett-Packard and 15 Ohmeda), Doppler BP, (Critikon-Dynamap), and temperature. Pressure ventilators (11 Infant star with star sync and 5 Bear Cub), HFO (4 Sensormedics 3100), pulmonary function test machine (Sensormedic), 2 Air borne life support transport systems with warmer vital monitor, and vent (Biomed ventilations), 2 back-up systems (Airshields TI-100), and 1 microvasive MC#8300 portable visicath system are available. Umbilical catheters, peripheral arterial catheters and percutaneous central venous lines are utilized (five staff are certified). Nurses perform routine Hct, U/A, accucheks and ISTAT labs. Blood gases are done ISTAT in the NICU. Cord gases are done in the main laboratory. Technicians are available 24 hours per day. An AMX-3 portable x-ray machine is located in the nursery and technicians are available 24 hours per day. A real-time occuson ultrasound machine is available 24 hours and radiology performs routine ultrasounds from 8am -5pm. A full time radiologist is in-house 24 hours. Technicians are available 8am to 5pm Monday through Friday for routine EKG's and 12-lead EKG's. Respiratory therapists (2/shift) are available 24 hours/day and check equipment hourly and are responsible for checking/recording ventilators/CPAP, TcO2, TcCO2, ETCO2, O2 saturation monitors.
The NICU serves as a training site for Quinsigamond College Respiratory Therapy Students who rotate with two NICU respiratory therapy instructors. There are generally two students who work two 12 hour shifts per week. A respiratory care plan is prepared in conjunction with the fellow and attending neonatologist. The nursing ratio is 1:2 (NICU), 1:4 (IICU) and 1:4-6(CCN). All nurses are well-trained and can perform procedures; such as IV and arterial punctures. Three full time, certified neonatal nurse practitioners are currently working in the NICU and round daily during the week and take night call with less well-trained residents. They are available for high risk deliveries and neonatal transports. Northeastern University NNP program uses MCCM NICU as a clinical training site.