Equipment in the ICN
Incubator
The incubator
is a transparent plastic housing, within which
an infant is cared for in a closely temperature-controlled
and sheltered environment. A temperature sensor
is taped to the baby's skin, and the incubator
heater adjusts to maintain the baby at a constant
temperature. Small premature infants are unable
to maintain their body temperatures adequately
due to a lack of body fat and a large surface
area, so the heated incubator is essential for
their care. Usually, infants will be placed under
a radiant warmer on admission to the ICN, and
then moved to an incubator when more stable.
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Infusion
Pumps
Infusion pumps are devices designed to administer
fluids at a precise, constant rate. They are used
for the delivery of intravenous fluids and many
medications. Infusion pumps can deliver fluids
either directly from a syringe mounted in the
pump, or from a hanging bag of fluid. Occasionally,
pumps may be used to administer tube feedings
over a specified period of time.
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Monitors
Infants in the ICN are typically monitored with
two types of devices:
- Cardiorespiratory monitor: connected to the
baby using wires taped to the chest. Heart rate
and breathing rate are displayed on the monitor.
If any abnormalities are detected by the monitor,
such as apnea or bradycardia, an alarm sounds.
- Pulse oximeter: shines a red light through
a hand or foot to determine the amount of oxygen
(oxygen saturation) in the blood. If the oxygen
level falls, an alarm sounds.
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Phototherapy
Lights
Infants with high bilirubin
levels (jaundice)
may be treated by exposure to light. The lights
used are either halogen spotlights, banks of fluorescent
bulbs, or a fiberoptic pad that is placed under
the infant. One or more phototherapy lights may
be used at a time. Bilirubin in the blood is exposed
to light as the blood flows through the skin.
The light changes the bilirubin to a form that
is nontoxic and can be eliminated more easily
from the body. The baby's eyes are covered during
phototherapy.
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Radiant
Warmer
The radiant
warmer is a bed with an overhead heating element.
A temperature sensor is taped to the infant's
skin, and the warmer regulates its heat output
to maintain the baby at a constant temperature.
Most babies admitted to the ICN will be placed
initially under a warmer for ease of care. When
stable, the infant may be moved to an incubator,
which provides a more sheltered environment.
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Ventilator
If an infant is having difficulty breathing,
a ventilator
(respirator) may be used. A tube (endotracheal
tube) is inserted through the mouth and into
the airway, and is connected to the ventilator
that provides breaths for the baby. The infant
becomes more comfortable and has improved levels
of oxygen and carbon dioxide in the blood. There
are two types of ventilators: conventional and
high frequency.
Conventional: A conventional ventilator
simulates normal breathing. The ventilator is
adjusted according to:
- The number of breaths per minute (breath rate)
- The pressures at which breaths are delivered
to the baby's lungs
- The amount of oxygen administered (ranging
from 21% [room air] to 100%).
High Frequency: The high frequency ventilator,
also called an oscillator, breathes for an infant
in a completely different manner from the conventional
ventilator. The oscillator delivers very rapid,
small breaths and is highly efficient. The ventilator
is adjusted according to:
- The frequency of breaths (10-15 breaths per
second, which equals 600-900 breaths per minute)
- The pressure at which the breaths are administered
(mean airway pressure)
- The volume of each breath (amplitude)
- The amount of oxygen administered (ranging
from 21% [room air] to 100%)
The oscillator is used when adequate support
cannot be achieved using the conventional ventilator.
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X-ray
Machine
The X-ray machine used in the ICN is portable
and can be rolled to the bedside, so infants do
not have to leave their beds for X-ray studies.
The amount of radiation used is very low, so that
there is little risk from even multiple X-ray
studies.
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