NICU Baby Monitors and Equipment
NICU Facilities – Babies will be closely monitored throughout their stay in the NICU. This means wires, tubes, patches, probes, and machines – which can all be scary. It can be difficult to watch your little one being poked and prodded and hooked up to machines. Knowing that it’s all for their own good, and understanding a little bit about what you’re seeing and hearing, may help to ease some of the fear.
Monitors
Your baby will be attached to one or more monitors that record and show his/her vital signs – heart rate, breathing rate, blood pressure, and the amount of oxygen in the blood – such as:- Small monitoring pads, called electrodes, which detect chest movement as your baby breathes. They also pick up the impulses of her heartbeat. Wires attached to the electrodes send the information to the monitor by your baby’s bed.
- A blood pressure monitor – checks periodically via a small cuff placed around your baby’s arm or leg. Invasive blood pressure monitoring is done by placing a small catheter in your baby’s artery and having advantage of continuous monitoring of blood pressure.
- A pulse oximeter, which is also known as an oxygen saturation monitor. This device measures the amount of oxygen in his/her tissues. The oximeter shines a small red light through your baby’s hand or foot to register the amount of oxygen in the blood. This number is recorded on one of the monitors by your baby’s bed.
- Electrodes placed on his head to monitor his brain. This type of monitoring is called amplitude-integrated electroencephalography or a EEG.
- A Transcutaneous monitors – It is used to measure oxygen and carbon dioxide through the skin. This monitor having a small circular piece attaches to the skin with adhesive. This piece heats up a tiny area of skin and can measure the oxygen and carbon dioxide level. Because the skin is heated, the circular piece may leave a red spot. The location of the piece is changed regularly. The red spots will fade over time.
Open Warmer or Incubator
When your baby is transferred to the NICU or SCN, he may be placed in an open warmer, an incubator, or a combination bed that can function as both an open warmer and an incubator. An open warmer is an open table that allows easy access to the baby and equipment. The heat comes from a lamp heater above the baby’s mattress. An incubator is an enclosed clear-plastic, box-like bed with an internal heat source. These pieces of equipment give your baby a controlled environment in which to grow and get better. A coated wire, called a temperature probe, is placed on your baby’s skin and is covered with an adhesive patch. The wire measures the baby’s temperature. This information is used to help regulate the amount of heat from the overhead warmer or incubator.
Respiratory support equipment at NICU
Suction catheter: This is used to remove mucus from your baby’s nose, throat, or trachea. It helps to decreases the chance of aspiration and keep the baby’s breathing tubes clear. There are devices used to give additional oxygen and minimise the breathing difficulty. These may include the following:- Nasal Cannula: This is a flexible, hollow tube with two small prongs that fit just below the baby’s nose to deliver a steady stream of oxygen.
- Nasal prongs: A tube with two prongs attached to it, these are placed inside your baby’s nostrils to provide a steady stream of oxygen. If the oxygen is delivered under pressure, it is known as CPAP (continuous positive airway pressure).
- Ventilator: A ventilator is a machine that provides additional breaths and oxygen to your baby as needed. A ventilator is attached to your baby by a small, plastic tube leading from the baby’s mouth to the windpipe. This tube is called an Endotracheal or ET tube. The ventilator sends air into your baby’s lungs through this tube. This tube is placed in to wind pipe (trachea) through the vocal cord. So there is no sound when the babies crying.
- Chest tubes – Your baby may need one or more chest tubes, especially if he/she has chest surgery, has a Pneumothorax (air or gas in the membranes surrounding the lungs), or has fluid accumulation in the membranes surrounding the lungs. A chest tube is a tube inserted in the space between the ribs and the lungs. It is aimed to remove excess air and fluid from the chest cavity to allow better expansion of the lungs and decrease the respiratory distress.
NICU Facilities – What is IV therapy equipment?
Babies who are premature, have breathing problems, or are too sick or stressed to receive medicine and nutrients by mouth will have intravenous or IV, therapy. Intravenous means “within a vein” IV therapy involves putting a small, flexible tube (called a catheter) into your baby’s vein to deliver fluids, nutrients, medicines, or blood. Your baby may also have an arterial line. An arterial line is similar to an IV line, except it goes into an artery instead of a vein. This line can be used to measure blood pressure or draw blood.
The IV pump
The IV catheter may be hooked up to an IV pump. An IV pump is a machine that helps to deliver exact amount of nutrients or other fluids delivered to your baby. An alarm on the IV pump may be set to indicate regular flow, also if there is any obstruction to the flow, which will draw the attention to check that everything is working correctly.
Umbilical Catheters
An umbilical catheter is inserted through the end of the baby’s umbilical cord into either an artery – an umbilical artery catheter or UAC or a vein (an umbilical vein catheter or UVC). The umbilical catheter is secured to the baby’s tummy with tape. You may also notice a small stitch at the base of the line. This stitch secures the line to the edge of the umbilical cord. The stitch won’t hurt your baby because there are no pain receptors or nerves in the umbilical cord.
The umbilical catheter has some advantages:- Blood samples can be painlessly drawn directly from either type of umbilical catheter for lab tests. This eliminates the need for your baby to be stuck with a needle each time he needs to provide a blood sample.
- With a UAC, the doctors and nurses can constantly monitor your baby’s blood pressure from within his body.
Peripheral lines
A peripheral line is an IV placed into the veins of arm, hand, leg, foot, or scalp. To place a peripheral line, a small needle is inserted into a vein that is close to the skin’s surface. Once in place, the needle is removed, and a catheter (small hollow tube) remains in place. The catheter will be secured so that the baby can’t pull it out. If the IV is placed in the arm or leg, it may be secured with an arm board – a small splint that helps prevent the IV from being accidentally pulled out. The site of a peripheral line needs to be changed frequently.
Central lines
A central line is catheter placed in the blood vessel that going directly to the heart. A central line must be placed by a doctor or a skilled nurse. It is better to give analgesics to make the baby comfortable before inserting the catheter.
PICC line is the most common type of central line. PICC stands for peripherally inserted central catheter .The catheter is inserted to a peripheral vein and it is guided into a larger vein draining directly to heart. After the insertion of catheter the position is confirmed with the X- ray. Complications of PICC line include bleeding, infection, and irregular heartbeat, migration of the catheter, and breaking or dislodgement of the catheter. The line may need to be removed if any of these occur.
Advantages of PICC line over a peripheral line:- It allows higher concentrations of nutrients and medicines to be given with less irritation to the veins.
- Able to use for long term and eliminates the need for multiple attempts to place IVs for nutrition, fluids, or medicines.
Photo-therapy for babies at NICU
Photo-therapy lights are used to treat a condition called jaundice. Jaundice is a condition in which excess accumulation of yellow color pigment called bilirubin, which gives yellow color to your baby’s eyes and skin. If your baby’s bilirubin level rises too high, he/she’ll be placed under photo-therapy lights. These lights help to decrease the bilirubin by increasing the excretion through urine and motion. Your baby will be undressed to allow as much of the skin as possible to absorb the light rays. The eyes should be covered to avoid direct exposure to light. The lights won’t burn or harm the skin. If your baby is undergoing photo-therapy, you should limit the time you hold him to allow maximum exposure to the lights.