Equipment is an important element of advancing neonatal intensive care. Three quarters of the world’s births and most of the newborn deaths happen where there is little access to equipment that can make the difference between life and death. Appropriate technology is sometimes called ‘poor solutions for poor people’ – but the opposite is needed, essential life saving equipment should not just be for rich countries. Technology does not have all the answers but it can make a big difference, however it must be suitable and affordable for the local context.
There is always a need for more equipment at regional and provincial hospitals. Our emphasis is on making sure the equipment is appropriate for the current nursing/medical skills and that there is a satisfactory support infrastructure for training and servicing. Standardisation of equipment is also important to minimise problems with training and use by all staff in the clinical setting. In addition to larger items of equipment, we try to ensure that there are enough basic items, neonatal sensors, blood pressure cuffs and that each baby has its own stethoscope, scissors and tape to reduce the risk of cross infection. The standard items of equipment are Infant Warmers, CPAP and Phototherapy machine.
Continuous Positive Airway Pressure (CPAP)
CPAP is a standard technology in developed world countries; it provides relief from respiratory distress and pneumonia, all problems common in premature and low birth-weight infants whose lungs are insufficiently developed. Pressurised air is delivered through prongs in the baby’s nose allowing continuous lung inflation.
CPAP has been instrumental in saving newborn lives around the world, and it remains one of the most important tools in the low-cost intervention lifesaving kit.
For neonates with more complex respiratory problems and who struggle to breathe independently a mechanical ventilator is required. The ventilator gives small puffs of air to support the continued growth of the baby’s underdeveloped lungs. This is one of the most critical pieces of equipment in a neonatal unit.
A closed incubator provides the optimal growing environment for premature and critically ill babies, balancing the right amount of heat and humidity, and in some cases oxygen. The incubator’s goal is to mimic, as much as possible, the environmental conditions that baby enjoyed in the mother’s womb.
Neonates and critically ill babies are unable to regulate their temperature and are highly susceptible to changes in external temperature and infection, a closed incubator allows babies to develop or be given lifesaving treatment in a controlled safe environment.
The infusion pump handles any medications, nutrients and other fluids that a neonate needs.
Monitors help doctors and nurses keep track of how the baby is doing. The monitor displays the baby’s heart rate, breathing rate, blood pressure and also the oxygen level in the blood.
A warmer provides radiant heat from above to keep the baby warm. Neonatal thermoregulation is a critical function for newborn survival. Hypothermia in the preterm or sick baby is closely associated with death. Less than 1°C separates a baby from cold stress and warm stress which divert energy away from breathing and growth towards the struggle of regulating body temperature.
This is a machine that monitors the amount of oxygen in the blood. A tape cuff is wrapped around the baby’s toe, foot, hand or finger. This machine allows nurses to monitor the amount of oxygen in the baby’s blood without having to obtain blood for laboratory testing.
Photherapy is provided by a machine usually placed over the infant warmer or incubator for treating newborn jaundice. Newborns are constantly making new red blood cells, and breaking down old ones. One of the waste products of old blood cells is a yellow substance called bilirubin. The newborn liver has a limited ability to process unconjugated bilirubin thus, infants are prone to an accumulation of unconjugated bilirubin, and can develop jaundice (hyper bilirubinemia). Approximately 10% of all newborns (including both term and neonates) require such intervention. Phototherapy systems shine a warm blue light over the baby that helps breakdown the extra bilirubin
Neopuff Infant Resuscitator
The Neopuff™ Infant T-Piece Resuscitator is an easy to use, manually operated, gas-powered resuscitator that provides optimal resuscitation.
Oxygen Flow Meter, Suction Regulator & Humidifier
These are essential basics for the care of sick newborns, these small but vital items control the flow of oxygen, pressure and suction. An oxygen flow meter is a device that measures the flow of oxygen from an oxygen-dispensing unit to the user of the oxygen, the newborn. Most hospital systems incorporate the oxygen flow meter as part of an oxygen regulator valve, but a flow valve can also be a separate device. The continuous suction regulator is designed to deliver constant vacuum for general suction procedures, including routine maintenance of the patient airway, oropharyngeal and endotracheal suctioning.