Shortfall of equipment for neonatal intensive care and the introduction of budget holding contracts.
(34/62)
As adequate allowance must be made for the costs of purchasing, maintaining, and updating equipment during the development of contracts the current standing of neonatal units with regard to available equipment was assessed. Data were collected as part of a one year prospective survey of the 17 perinatal units in the Trent region. Adequacy of provision of equipment for recognised intensive care cost was assessed using the recommendations of the British Paediatric Association and British Association of Perinatal Paediatrics. It was assumed that units without recognised intensive care cost had to be able to equip one cot to a standard of intensive care level 1 in the short term. Equipment more than 5 years old was considered likely to warrant replacement or major maintenance within the next two years. With these guidelines over 600,000 pounds would be required to provide sufficient equipment for all recognised level 1 intensive care cost and to allow units without funded cost to provide this level of care in the short term and to replace existing equipment more than 5 years old for these cost alone. This amount could be reduced by 25% by subdividing intensive care cost into levels 1 and 2, thereby reducing equipment requirements, but this would impair the units' ability to perform level 1 care at funded provision, which has already been shown to need expansion. Neither figure takes account of equipment requirements for infants requiring special care. In addition, no allowance has been made for purchase or update of ultrasound scanners or blood gas analysers. If the government's proposed reforms are to be implemented clinicians need to revise guidelines regarding essential equipment, and plans must be made to correct any existing shortfalls so that they do not become inherited financial liabilities for future budget holders. (+info)
Assessment and certification of neonatal incubator sensors through an inferential neural network.
(35/62)
Rewarming preterm infants on a heated, water filled mattress.
(36/62)
Sixty low birthweight infants (1000-2000 g) admitted to a neonatal care unit in Turkey were studied. Those not requiring intensive care were randomly assigned for treatment either in a cot on a heated, water filled mattress kept at 37 degrees C (n = 28) or in air heated incubators with a mean air temperature of 35 degrees C (n = 32). On admission 53 (88.3%) of the infants had body temperatures between 30 degrees and 36 degrees C. There was good correlation between axillary and rectal temperatures in the infants while they were hypothermic. Normal temperatures were achieved within the first day and remained within this range during the subsequent days after admission in all the infants treated on the heated, water filled mattress, whereas they were not achieved until three days later in the incubator group. The neonatal mortality among those treated on the heated, water filled mattress was 21%, and among those treated in the incubator 34%. The heated, water filled mattress provides a good alternative to skin to skin contact with the mother, and to the use of a complex and expensive incubator for rapidly attaining and maintaining normal temperatures in the low birthweight newborn. (+info)
Providing warmth for preterm babies by a heated, water filled mattress.
(37/62)
Seventeen healthy preterm babies had extra warmth provided in their cots by thermocontrolled, heated, water filled mattresses. As controls 17 babies of the same weight were nursed in air heated incubators. Both groups were studied for three weeks. No differences were found in minimal oxygen consumption (measured by indirect calorimetry), rectal and mean skin temperatures, or in daily weight gain. The babies were kept just as warm on the heated, water filled mattresses as in air heated incubators but the mattresses had the advantage of giving the mothers easy access to their babies. (+info)
New insulating material in maintenance of body temperature.
(38/62)
Flectalon, web of aluminised polyvinylchloride fibres, has been formulated to minimise radiant heat losses and to provide conventional insulation. Critical temperature determinations were used to assess the insulating efficacy of this and other swaddling materials in infants. The critical temperature for a baby 2 to 10 days old was 31 degrees C when naked and 23 degrees C when wrapped in a Silver Swaddler or a sheet and two blankets. The use of a quilt made with Thinsulate or Hollofil with a mass per unit area of 160 to 180 g/m2 reduced the critical temperature to 19.5 degrees C, while Flectalon of comparable weight reduced the critical temperature to 13.8 degrees C: Flectalon is thus an efficient insulator. The risk of overheating was studied by monitoring swaddled babies, rectal temperatures at various ambient temperatures. Some forms of swaddling caused increases in rectal temperatures at "normal' hospital temperatures, implying risks from warmer environments and assessments of swaddling materials should, therefore, include medical evaluation of efficiency and safety. Flectalon merits assessment in other groups at risk from hypothermia. (+info)
Humidification of incubators.
(39/62)
The effect of increasing the humidity in incubators was examined in 62 infants of less than 30 weeks' gestation. Thirty three infants nursed in high humidity for two weeks were compared retrospectively with 29 infants from an earlier study who were nursed under plastic bubble blankets or with topical paraffin but without raised humidity. Humidification reduced skin water loss and improved maintenance of body temperature from birth, but did not delay the normal postnatal maturation of the skin. Infants nursed without humidity frequently became hypothermic in spite of a high incubator air temperature. These advantages must be weighed against the finding that overheating was more common and Pseudomonas was more commonly isolated from the infants. It is recommended that incubator humidity is raised for babies under 30 weeks' gestation in the first days of life but meticulous attention should be paid to fluid balance, avoiding overheating, and cleansing of the humidifier reservoir. (+info)
Length measurement in small neonates.
(40/62)
The Prematometer is a new instrument for the accurate measurement of the length of small neonates inside incubators. It is capable of giving precise results. (+info)