infant incubator use training by cyril 2.11.12
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INFANT INCUBATORUser Training on 02ndNovember 2012
Venue : SWCH
Time : 9:00 am
Presented By : Cyril Soidi
Technical Executive
BEMS
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Infant Incubator
Infant incubator is a Bio Medical Device
which provides Warmth, Humidity andOxygen all in a controlled environment asrequired by the new born.
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History
1891 First modern Incubator invented by Dr.Alexandre Lyon
1898
First American Incubator Hospital set up
at the Trans Mississippi Exposition inOmaha, Nebraska.
1901
The World famous Pan American
Exposition was held in Buffalo, NewYork. For 10 cent admission fee peoplecan go in and see
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History
1907 Pierre Constant Budin released study of theInfluence of Body Temperature on InfantMortality.
1932 Julius Hess in his patents for incubatorsproposed a mechanism for the addition ofsupplemental oxygen in the Incubator.
1933 Blackfan and Yaglaw released report on theImproved Survival for New Born InfantsNurtured in Humidity Enriched Environment.
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History
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History
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Principle
The infant incubator is normally in theform of a trolley with a small mattress on
the top covered by a rigid clear plasticcover. This chamber provides a cleanenvironment, and helps to protect the
baby from noise, drafts, infection, andexcess handling.
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Principle
A temperature sensor is taped to thebaby's skin, and the incubator heateradjusts to maintain the baby at a constanttemperature or the temperature iscontrolled by a thermostat in the heatedair stream.
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Principle
Underneath the baby is an air-blownelectric heating system and humidification
system which circulates heated humid airat a desired temperature and humiditythrough the incubator chamber.Additional oxygen may also be introducedinto the chamber.
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Principle
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Anatomy
Skin
Skin is often considered the largest organ system ofthe human body.
The average adult male has 18 square feet of skinweighing over 6 pounds.
Skin is comprised of three layers, the Epidermis,Dermis and Subcutaneous tissue.
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Anatomy
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Skin
EpidermisOuter Layer of the Skin.Contains up to 5 layers.Thinnest in eyelids and thickest in soles.Continuously regenerates itself.
DermisMiddle Layer of the Skin.They contain blood vessels, hair follicles, oil and gland and
nerve endings.They transmit sensation of pain, itch and temperature
Subcutaneous TissueMade up of fat and connective tissue.Houses larger blood vessels and nerves.Regulates body temperature.
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Skin Function
Provides a physical barrier to the outside environment.
Assists in the development of the immune system.
Conserves body fluid by preventing evaporative loss.
Maintains body temperature.
Excretes water and oils.
Produces vitamin D in the presence of sunlight.Provides sensations of temperature and touch.
Stores water, fat, and vitamin D.
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Important Parameters
Temperature
Humidity
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Body Temperature
Normal core body temperature can range between98.9 F and 99.9 F.
Cells, tissues and organs operate efficiently only within
this narrow temperature limits.
If the temperature rises 2F above the normal of98.6F, we become ill. If it rises 7F, we become
critically ill.
If our temperature decreases 2F, we feel cold. A 7Fdecrease puts our life in jeopardy
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Hypothermia
It occurs when core body temperature dropsto 95F or lower
Happens when heat loss exceeds heat gain
New born with temperature below 36.0-36.4C (96.8-97.5F) is in moderate Hypothermia
Remedy
Skin-to-skin contact with the mother.Use a heated water-filled mattress.Use radiant heater.Use Incubator.
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Hyperthermia
Hyperthermia can be defined as a core temperature greaterthan 98.6 F (37.0 C)
In adults it may lead to fever, heat syndromes like collapse,cramps, stroke etc.
An external source like
Overzealous re-warming
Poorly serviced equipment
Misuse of warming lamps Incubator too close to a sunny window
Temperature probe not in good contact
with the skin
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Hyperthermia
Hyperthermia in Neonates can lead to :
Increased oxygen requirements
Apnea
Dehydration Metabolic acidosis
Heat stroke, brain damage, shock and
even death.
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Heat Loss
Heat loss that happens when water evaporates fromskin and respiratory tracts.
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Heat Loss
Heat loss to cooler surrounding air.
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Heat Loss
Heat loss to cooler objects which are in direct
physical contact.
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Heat Loss
Heat loss to cooler solid objects which are not indirect physical contact.
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Thermoregulation
In Uterus
Baby is essentially a cold blooded creature
unable to thermo-regulate like adults
It therefore adapts to the mothers core
temperature.
The baby's core temperature is generally
0.5 C above the mother's core temperature
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Thermoregulation
Neonatal Risk
Have limited thermoregulatory ability
Rely on external heat to maintain their coretemperature.
Thermal instability can last for several days
or even weeks!
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Application
NICU
SCN.
Post natal care wards.
Transport Incubators can be found in Labor wardto transport the new born to Post natal wards orNICU.
Hospitals that dont have a dedicated NICU willhave a transport incubator so that critical newborn can be shifted via ambulance or helicoptersto the nearest hospital having an NICU facility.
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Types - Radiant Warmer
The radiant warmer is a bed with an overhead heating element.
A temperature sensor is taped to the infant's skin, and thewarmer regulates its heat output to maintain the baby at a
constant temperature
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Radiant Warmer
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Radiant Warmer
Advantages
Allows physicians and nurses to have easy access to the babyfrom all sides during the most critical period.
Disadvantages
Baby is open to all the disturbance and infection in the NICU andit is difficult to control Humidity.
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Types Infant Incubator
The incubator keeps the baby warm with heated moist air in aclean environment.
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Transport Incubator
A transport incubator is used when a sick or premature baby ismoved from one hospital to another
It is similar to the Infant Incubator but is battery powered
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Noise
Premature babies are fragile. One of their special needs is quietenvironment. However, in the neonatal intensive care unit(NICU), high noise levels and frequent handling leave the babiessleep deprived and may disrupt their normal growth and
development.
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Noise
These noise induced health effects on the infant are
Hearing Impairment
Sleep disturbance
Somatic Effects
Auditory Perception and Emotional Development
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Avoiding Noise
No tapping or writing on top of the Incubator or hood.
Careful and soft closure of the Incubator pot hole doors.
Neonatal Noise mufflers can be used.
Medical staff should be advised to wear soft shoe.
To identify noisy areas and to isolate them.
Check existing machines for noise level
Check all incoming new machines for their noise
level before being put to use
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Noise Levels
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Maintenance
User Maintenance
Cleaning
Disinfection
Functional Checks
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Cleaning
Procedure
Clean all porthole seals and Hood seals partswith a solution of general purpose neutral
detergent and warm water.
Clean frame, mattress and accessories with asolution of general purpose neutral detergent
and warm water, applied with a disposablewipe.
Clean the oxygen inlet with mild cleaningsolution.
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Cleaning
Reusable Patient probes can be cleaned by soaking theprobe tip and wire in a cleaning solution. Theconnector tip should not be soaked.
Pat the probe tip and wire with a clean cloth to dry it.
Clean the castor wheels and remove the lint and dirtaccumulated in it
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Disinfection
Procedure
If used by infected babies , after cleaning, wipe over with achlorine-releasing agent rinse and dry thoroughly.
If visibly contaminated with blood or faeces, clean asabove then wipe it with a chlorine releasing agent, rinseand dry.
Phenolic or alcohols should not be used as they willdamage the waterproof coating of the mattress cover.
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Functional Checks- Mechanical
Check the Incubator exterior especially the plexi glassfor any signs of damage.
Check the braking system in the wheels work properly.
Check the Hood seals are placed properly.
Check that the access ports can be opened and closedproperly.
Check the Hood tilt latch. Verify its locking and release
mechanism is OK.
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Functional Checks- Operation
Switch on the machine and make sure that the self checkpass successfully.
Check whether the Manual and Servo mode can beselected.
Check the switch for Selection of Temperature unit(Centigrade or Fahrenheit)
Check whether the set Temperature can be raised andlowered.
Check whether the set Humidity can be raised andlowered.
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SafetyDo not leave any patient inside the Incubator unattended
for a long time.
Humidifier compartment should be fixed even if it is notused.
Do not place the Infant Incubator in direct sunlight orother source of light as it might overheat the infant.
If ambient temperature is higher than set value thenIncubator will be ineffective.
When oxygen is administered always check the level usingan independent oxygen monitor
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Safety
Use only the temperature probe recommended bymanufacturer
The Incubators air circulation and Ventilation ports
should not be obstructed otherwise heat loss and CO2build up will happen.
For post operative patients care should be taken as
the residual anesthetic gases exhaled by the patientcan be decomposed by the heater to produceformaldehyde.
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Electro Magnetic Hazard
Studies of a possible relation between exposure toextremely low-frequency magnetic fields and sometypes of childhood leukemia indicate that most of the
power frequency magnetic field measured in theincubator originates from the fan blower motor ratherthan the electric heating coils. If this supposition iscorrect, it can be easily reduced by using different fanmotors, by magnetic shielding, or by relocating theincubator motor further from the infant.
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