Incubator careIncubator care

Supervised By: Dr.Huda WahedSupervised By: Dr.Huda Wahed

Prepared By : Mohammed ibrahim Ali ObiedPrepared By : Mohammed ibrahim Ali Obied

ID :24883ID :24883

incubator care:incubator care:

New born babies take time to accustom to the external environment New born babies take time to accustom to the external environment specially if they one premature and low birth weight. As they are on specially if they one premature and low birth weight. As they are on risk to develop hypoxia, hypothermia and other many associated risk to develop hypoxia, hypothermia and other many associated adverse conditions, need special care and attention.adverse conditions, need special care and attention.

Application of oil or liquid paraffins to the skin of the babies Application of oil or liquid paraffins to the skin of the babies either inside the incubator or outside reduces the heat loss by either inside the incubator or outside reduces the heat loss by 50%. If is very essential for baby to obtain an ideal environment 50%. If is very essential for baby to obtain an ideal environment for growth and development, basically survival itselffor growth and development, basically survival itself..

Indications:Indications:

Indication of incubation care depends on ability of neonates to sustain Indication of incubation care depends on ability of neonates to sustain andandadopt in external environment. But generally all premature babies.adopt in external environment. But generally all premature babies.

1. babies with low birth weight(<1000g) may be stable.1. babies with low birth weight(<1000g) may be stable.

2. hypothermic child (<32˚c).2. hypothermic child (<32˚c).

3. Sick children need care3. Sick children need care..

Purpose:Purpose:

Main purpose of keeping and caring a neonate in incubator are.Main purpose of keeping and caring a neonate in incubator are.

1. 1. Maintenance of thermo neutral ambient temperature.Maintenance of thermo neutral ambient temperature.

2. 2. Provision of desired humidity and oxygenation.Provision of desired humidity and oxygenation.

3. 3. Observation of very sick neonates.Observation of very sick neonates.

4. 4. Isolation newborn babies from infections, unfavorable external Isolation newborn babies from infections, unfavorable external environment and stimulationsenvironment and stimulations..

Types:Types:

1. 1. Portable and non portablePortable and non portable–– Portable incubation can be used to shift Portable incubation can be used to shift the patient toanother area of hospital as needed.the patient toanother area of hospital as needed.

2. 2. Open box type.Open box type.

3. Close type - Close type of incubator has special function to 3. Close type - Close type of incubator has special function to concentrate fresh air after filtration. It prevents water loss from concentrate fresh air after filtration. It prevents water loss from radiation. As neonate remain inside the box the risk f infection is radiation. As neonate remain inside the box the risk f infection is minimum.minimum.

4. 4. Double walled-Double walled- The incubator has two walls. As air is not good The incubator has two walls. As air is not good conductor of heat the incubator prevents heat and fluid loss.conductor of heat the incubator prevents heat and fluid loss.

5. 5. Servo control incubatorServo control incubator..

Ideal settings of incubator:Ideal settings of incubator:Setting of incubator depends upon various parameters of neonate as Setting of incubator depends upon various parameters of neonate as

well as environment e.g. gestational age, maturity, body well as environment e.g. gestational age, maturity, body temperature and presence or absence of disease. Recommended temperature and presence or absence of disease. Recommended

Nursery temperature is 28-30c. The incubator temperature should be Nursery temperature is 28-30c. The incubator temperature should be such asset will maintain the temperature of neonate between 35-38c.such asset will maintain the temperature of neonate between 35-38c.

Neutral range of Environmental temperatureNeutral range of Environmental temperatureageage<<1200120012011201 - -150015001501-25001501-2500>>25002500

1st day1st day35.035.0 ± ± 0.50.534.334.3 ± ± 0.50.533.433.4 ± ± 1.01.033.033.0 ± ± 1.01.0

2nd Day2nd Day34.534.5 ± ± 0.50.533.733.7 ± ± 0.50.532.732.7 ± ± 1.01.032.032.0 ± ± 1.01.0

3rd Day3rd Day34.534.5 ± ± 0.50.533.533.5 ± ± 0.50.533.033.0 ± ± 1.01.032.032.0 ± ± 1.01.0

4th Day 4th Day and laterand later

33.533.5 ± ± 0.50.532.832.8 ± ± 0.50.532.232.2 ± ± 1.01.031.531.5 ± ± 1.01.0

A humidity of 60-70% is sufficient under most circumstances. Oxygen A humidity of 60-70% is sufficient under most circumstances. Oxygen delivery inside the incubator depends on well being and ability of delivery inside the incubator depends on well being and ability of neonate to adapt in external environment but 7-10 lit/min of Oxygen neonate to adapt in external environment but 7-10 lit/min of Oxygen provides adequate oxygen to the neonate unless neonate has some provides adequate oxygen to the neonate unless neonate has some pathology.pathology.

Procedure-Procedure-

Warm and oxygenate the incubator as you receive the message of Warm and oxygenate the incubator as you receive the message of expected arrival of neonate, generally 10-15 minutes earlier.expected arrival of neonate, generally 10-15 minutes earlier.

Check the physician Check the physician’’s order.s order.

Explain the needs of incubator care to the parents of neonate. Explain the needs of incubator care to the parents of neonate.

Adjust the incubation parameters and maintain, follow the chart. Adjust the incubation parameters and maintain, follow the chart.

Remove the cloths of the neonate and place inside the incubator Remove the cloths of the neonate and place inside the incubator..

Provide meticulous care as long neonate remains in side.Provide meticulous care as long neonate remains in side.

Continue care through port hole. Continue care through port hole.

Report to the doctor if baby is not maintaining the temperature, Report to the doctor if baby is not maintaining the temperature, generally after two abnormal readings.generally after two abnormal readings.

Do not bring the neonate out without justifiable cause. Do not bring the neonate out without justifiable cause.

Document time and condition of the neonate. Document time and condition of the neonate.

In open care system, cover the baby with warm cloths or to In open care system, cover the baby with warm cloths or to minimize heat lossminimize heat loss..

Cleaning and sterilization:Cleaning and sterilization:

When the incubator is occupied, it should be cleaned daily with mild When the incubator is occupied, it should be cleaned daily with mild detergent. Humidifier chamber must be emptied and cleaned daily, fill detergent. Humidifier chamber must be emptied and cleaned daily, fill with fresh distilled water. After seven days neonate should be sifted to with fresh distilled water. After seven days neonate should be sifted to another incubator and used incubator should be cleaned with another incubator and used incubator should be cleaned with antiseptic solution.1-2 ml of Glacial acetic acid or vinegar can be antiseptic solution.1-2 ml of Glacial acetic acid or vinegar can be added to water in the humidifier to prevent bacterial growthadded to water in the humidifier to prevent bacterial growth..

Special considerations :Special considerations :

1. It is important that the incubator should not interfere with 1. It is important that the incubator should not interfere with observation of the neonate and quality of care.observation of the neonate and quality of care.

2. Sensory stimuli like light and pain should be kept to the minimal.2. Sensory stimuli like light and pain should be kept to the minimal.

3. When neonate develops fever, the incubator modes have to be 3. When neonate develops fever, the incubator modes have to be changed in normal modes.changed in normal modes.

4. When the neonate is nursed in prone position, skin sensor is 4. When the neonate is nursed in prone position, skin sensor is placed over the flank and it should not touch the bed.placed over the flank and it should not touch the bed.

5. The neonate in the incubator should not be bathed.5. The neonate in the incubator should not be bathed.

6. No alarm should be ignored6. No alarm should be ignored..