Difference between Level I and Level II for L&D

SmilingBluEyes · Sep 5, 2005

Not a whole lot....

Level 3 is where you see the sickest of the sick pregnant women go for care....

women who:

Have severe cardiovascular/respiratory disease processes that compromise their pregnancies and lives

Severe complications of PIH,

SmilingBluEyes · Sep 5, 2005

Level 1 really is reserved for VERY low risk patients.....most Level 1s do not care for patients needing anything beyond basic L/D care.

they generally do not do

magnesium sulfate therapy

insulin drips

complicated antenatal care (including the above)

complicated cases with multiple medical histories etc.....

The difference between Level 1 and 2 is not very appreciable. the real difference becomes when you go from Level 2 to 3. 3 is where you get it allllllll

complicated cases involving women and/or fetuses with disease processes compromising their health and lives

cases of deliveries at less than about 34 weeks' gestation

cases where a known major anomaly of the newborn is expected

women who require intensive care-environment for their pregnancy/delivery and postpartal course...........

You will typically see these at major teaching hospitals/university health systems and large metropolitan health care centers. They may take patients from 100s or even over a 1000 miles away, cause they are the only center they can get to where the level of care needed can be provided.

Hope this helps.

newnurse.rs · Sep 5, 2005

Thank very much for your responses. Actually they have helped me alot :)

SmilingBluEyes · Sep 5, 2005

rofl the first post was incomplete when my computer inexplicably shut down.....

so there it stands all screwed up.

hence, the 2nd post.

glad it helped.

NurseNora, BSN, RN · Sep 10, 2005

It used to be that the Level I, II, or III applied to the nursery, not L&D. Has that changed? Mother is the best infant transporter known, so when a baby is likely to need specialized care after it is born, ideally it is transported to a hospital with a higher level nursery while it is still inside.

Level III hospitals have NICU's that can care for the smallest and the sickest of babies. Level II nurseries can care for premature and sick infants, Level I can take care of healthy term newborns. At my current hospital, a Level I, we transport anyone less than 35-36 weeks (who's preterm labor we can't stop), anyone with known fetal anomalies, anyone whose baby is likely to need specialized care.

We run Mag for PTL and for PIH. If we cant stop the labor, or if the PIH is likely to require that the baby be delivered early, we transport, but term preeclamptics can stay.

We can run IV's on our babes and O2 (since we're more than a mile above sea level, we run a lot of O2, and those babies are allowed to be in the room with mom with O2 and a pulse oximeter--but that's a discussion from another thread). But if they need more than that, or if we can't wean them off O2 in a couple of days, they go to a higher level facility.