The equipment on the neonatal unit

Neonatal units are full of equipment that you may not have seen before. It is all there to give your baby the best possible chance of survival and a healthy future.

Incubators

A basic need for your baby is to keep warm. Placing a premature or vulnerable baby inside an incubator will help do this. Some incubators are closed boxes with hand-sized holes in the side and mechanisms to circulate air inside. Being in a closed box not only keeps the heat in, but also helps doctors to control the humidity around the baby. This prevents the baby from losing too much moisture by evaporation from his or her fine skin.

Other incubators have open tops and often have an overhead heater. These can give staff greater access to the baby. The temperature inside the incubator can be regulated in two ways. It can be set manually with the controls or set to automatically respond to information about the baby’s temperature that is picked up by a small sensor his or her skin. If the sensor falls off, or does not pick up the baby’s temperature, this will trigger an alarm so that a nurse can make sure the incubator does not become too warm.

Vital signs monitors

Small pads may be placed on the baby’s chest with cables running to a monitor. These pick up the electrical signals given out by the baby’s heart and constantly check that it is beating properly. The pads can also detect changes during breathing, and pauses in breathing may trigger an alarm.

Blood oxygen monitors

Another device is normally strapped gently to the baby’s foot or hand. This shines light through the skin and monitors the amount of oxygen in your baby’s blood.

Ventilators

In the mother’s womb, a baby receives all of the oxygen he or she needs from the mother’s blood and it is passed to the baby’s blood in the placenta before travelling to the baby through the umbilical cord. Once born, all babies have to get their own oxygen by breathing.

This can be a particular problem for very premature babies. There are two main reasons. Firstly, the lungs may not be fully developed, and secondly, the baby may be unwell and very weak. If your baby's lungs are not fully developed, doctors may use a tube to pass a chemical called surfactant directly into his or her lungs. Surfactant is a natural substance produced in the unborn baby's lungs from approximately 20 weeks. It helps to reduce the tension on the surface of the lungs and makes breahing easier. Premature babies may not have developed enough surfactant, which can lead to respiratory distress syndrome (RDS).

To help the babies breathe, doctors may also use a ventilator. This machine drives air through a tube placed into the baby’s windpipe (the trachea). There are two basic types of ventilators in use and others are being developed.

Positive pressure ventilators blow oxygen-enriched air gently into the baby’s lungs through a tube that is passed through his or her mouth or nose. These ventilators inflate the lungs. The rate of breathing will be regularly adjusted to meet your baby’s needs. These sophisticated machines are designed to reduce damage to your baby’s lungs.

High frequency ventilators work by vibrating the chest hundreds of times a minute. This is a natural process that is much like the panting style of breathing that dogs do after a long walk on a hot day and many babies find this very settling.

Gentle breathing support (CPAP)

Some babies need a little help with their breathing, but do not need a ventilator. They can be helped with Continuous Positive Airway Pressure (CPAP). This is when air flows through two fine tubes placed in the baby’s nostrils or through a small mask over the baby's nose. This slightly raises the pressure and helps to keep the baby’s lungs inflated.

If CPAP is used for a long time, the pressure of the nosepiece on the tip of the nose can give the baby a snub-nose appearance. Sometimes breathing support may be given via a tube inserted into only one nostril, and this may enlarge the nostril if used for a long time. This technique is becoming less and less popular though, and with modern fixing techniques, it seldom damages the inside of the nose.

Apnoea alarms

When babies are on a ventilator, it doesn’t matter if they take a pause in their breathing. Once the ventilator has been removed, any pauses are more of a problem. CPAP can help, but babies may also be fitted with a monitor which checks that they are breathing regularly. These set off an alarm if the baby pauses for too long between two breaths.

* Copy courtesy of Bliss

Vital signs monitor

Some incubators are closed boxes with hand-sized holes in the side

equipments

Blood oxygen monitor

equipments

Commonly used ventilator

equipments

CPAP