care of child with incubator
TRANSCRIPT
Care of child with incubator
Introduction Incubator is an apparatus for
maintaining an infant,especially a premature infant, in an environment of controlled temperature, humidity, and oxygen concentration.(Online medical dictionary).
Incubators have simple alarm system to
alert the clinical staffs if there is any danger
of overheating of the device.In some cases
power is reduced automatically to prevent
overheating
Principle of IncubatorInfant incubator is in the form of trolley
normally with mattress on the top covered by plastic cover. This chamber provides a clean environment and helps to protect the baby noise, infection, and excessive handling.
Principle of IncubatorA temperature sensor is tapped into the
baby’s skin and the incubator heater adjusts to maintain the baby at a constant temperature or the temperature is controlled by thermostat in the heated air stream.
Purpose of IncubatorAn infant may require an incubator for the
following reasons:When they are not maintaining their own temperature with
clothing and wrapping.When they are acutely unwell and close observation is required.When they are at risk of abnormal heat loss.They have a known infection/ or the potential to develop sepsis.
Purpose of IncubatorMain purpose of keeping and caring a
neonate in incubator are1. Maintenance of thermoneutral
ambient temperature2. Provision of desired humidity and
oxygenation3. Observation of very sick neonates4. Isolation newborn babies from
infections, unfavorable external environment
Main functions of infant incubators are:
1.Temperature control
2.O2 Concentration
3.Humidity control
4.Breathing gas filtration
Indications of incubator Indication of incubation care depends on ability of
neonates to sustain and adopt in external environment. But generally all premature babies, babies with low birth weight(<1000g) may be stable, hypothermic child (<32˚c), Sick children need luenbotor and its care.
Frequently incubator is used to transport babies from one place to another, like referral to another hospital, within the hospital for various investigations e.g. CT scan & MRI. Neonates who need close observation are also kept in the incubators.
Types:
Incubation can be of various types1. Portable and non portable– Portable incubation
can be used to shift the patient to another area of hospital as needed.
2. Open box type- It is also known as Armstrong, here neonate is keep on the Plexiglas bassinet to keep unstable babies or newly born babies. A radiant warmer can be attached if child needs.
The main disadvantage of this type of incubator is it
can not maintain thermoneutral environment if lids are
open frequently. Despite it can not filter the air and
neonate is directly in the contact with external
environment. It has only advantage that neonate in this
incubator can be observed well and can be handled
easily.
3. Close type - Close type of incubator has special function to concentrate fresh air after filtration. It prevents water loss from radiation. As neonate remain inside the box the
risk of infection is minimum.4. Double walled- The incubator has two walls.
As air is not good conductor of heat the incubator prevents heat and fluid loss.
STEP 1.Prepare the incubator
Pre-warmed to a temperature appropriate to the infant’s age, size and condition.
Use in Air mode and must always be switched on with the motor running if in use for a baby.
Check and record the incubator temperature hourly.
Position away from draughts or direct sunlight.
NURSING CARE OF CHILD IN INCUBATOR
Note: Ensure alarms self-test has been
completed (automatic). If the unit fails the
self test, the alarm sounds, and one or
more messages are displayed in the
trend/alarm window.
STEP2:Care of Baby
Maintain axilla temperature between 36.5°C and 37.2°CAccess baby by using the portholes, limit opening of
large door as this interferes with air temperature.Ensure baby is nursed naked apart from a nappy.Position baby utilizing rolled towels/cloth nappies to
provide boundaries that support ‘nesting’ and flexion of limbs but keeping face clear
Explain to parents/caregivers the purpose of an incubator for their baby
Ensure they are familiar with how to access baby as it is optimal for parents to continue to touch and provide comfort.
Maintain a quiet environmentThere is no tapping on the canopy.No equipment is placed on top of the canopy.Careful opening and closing of doors.
STEP 3:Adjusting incubator temperature
Default incubator temperature in NICU is 35 degrees
Adjust the incubator temperature by no more or less than 0.5 of a degree at a time.
Re-check the temperature within half an hour of making any adjustment.
STEP 4:MonitoringAxilla temperature is taken on admission
into the incubator and rechecked in the first hour.
Temperature is documented 4-6 hourly as per the condition.
STEP 5: Use of Humidification Is utilized
for incubator care of preterm babies only –
NOT required for babies >32weeks.
Cleaning and sterilization
When the incubator is occupied, it should be cleaned daily with mild detergent.
Humidifier chamber must be emptied and cleaned daily, fill with fresh distilled water.
After seven days neonate should be sifted to another incubator and used incubator should be cleaned with antiseptic solution.
1-2 ml of Glacial acetic acid or vinegar can be added to water in the humidifier to prevent bacterial growth.
Special considerations-
1. It is important that the incubator should not interfere with observation of the neonate and quality of care.
2. Sensory stimuli like light and pain should be kept to the minimal.
3. When neonate develops fever, the incubator modes have to be changed in normal modes.
4. When the neonate is nursed in prone position, skin sensor is placed over the flank and it should not touch the bed.
5. The neonate in the incubator should not be bathed.
6. The daily linens should be kept within the Nursery to keep warm.
7. No alarm should be ignored.