All good neonatal units follow protocol-based management of sick neonates for uniform standard clinical care. Consenting to follow the agreed protocols serves as a catalyst for new ideas to improve clinical care. These protocols however must be viewed as generic in nature. Suitable adaptation may be done at individual centers through the process of consultation with other team members. As new evidence emerges, and ones own experience becomes richer, the protocols will need to be updated and revised.
Our unit at AIIMS published a series of protocols in IJP in the year 2003, 2008; these protocols have been revised and modified in the light of current emerging evidences and changing practices in our unit and published for wide spread dissemination by CBS Publishers , New Delhi . With use of antenatal steroids and early use of CPAP, the babies needing invasive ventilation has declined. Similarly with better monitoring of oxygen therapy, rational use of blood transfusion and improved supportive care, over the last decade the number of babies needing intervention for retinopathy of prematurity has gradually decline. This happened as nurses and physicians followed standard protocols laid in house for management of sick babies. We are sure many of you who would adhere to these evidence based guidelines will notice better outcomes in survivals on follow up.
The editors are grateful to all those who have contributed for compilation of these evidence based protocols. One can access the protocols on our website www.newbornwhocc.org. We would welcome suggestions and comments, if any, which will improve quality of care of sick neonates in resource poor developing countries.
Dr Ramesh Agarwal , Prof. A.K. Deorari & Prof. V.K. Paul
Division of Neonatology
Department of Pediatrics
All India Institute of Medical Sciences
Ansari Nagar, New Delhi - 110 029