Your baby may need a number of routine tests or procedures during his/her time on the Neonatal Unit and we will not specifically ask for your permission to perform these. Doctors and nurses will be happy for you to ask questions and to discuss the results of any tests with you.
Consent
There are some procedures, treatments and research programmes that may require you to give your consent (permission), either verbally after discussion with a doctor or in some cases by completing a written consent form (surgery, hearing screening, PKU blood test , immunisations).
Communication and confidentiality
Your baby’s medical and nursing notes are legal documents and remain the property of the Trust. Information regarding your baby’s condition will only be shared with parents and other relevant health professionals, such as your baby’s GP or health visitor.
Monitoring your baby
After the initial assessment, babies are monitored to provide a continuous assessment while they may be unwell or premature.
The monitors are at the cot space and look like a computer screen. The monitors are set to alarm if there are readings outside limits set by the neonatal team. The alarms can be one of the most frightening aspects for parents in the Unit. Staff will always respond to the alarms, but frequently the alarms sound if the baby wriggles or if one of the probes is dislodged. Monitors are a guide to your baby’s wellbeing and the team will also watch your baby closely for any changes in their colour and condition.
Heart rate and breathing are monitored by placing three soft, sticky electrodes (ECG electrodes) to your baby’s chest and abdomen.
Blood pressure can be monitored by two methods. The non-invasive method requires a small cuff that fits either around the arm or leg (similar to how most adults have their blood pressure taken). Sometimes babies require more continuous blood pressure monitoring. We do this by connecting a blood pressure device to an arterial line inserted by the doctors. The arterial line is also helpful because bloods can be taken from it without disturbing the baby.
Oxygen levels are monitored by a small non–invasive probe, which is usually placed on the hands or feet. The probe helps determine whether the baby requires additional oxygen or respiratory support.
We also monitor their temperature using temperature probe under the arm. If the baby needs continuous temperature monitoring a probe is placed on the skin with a small sticky patch over it to hold it in place.
Equipment to help with your baby's breathing
Many babies in the unit need some help with their breathing. There are many reasons why they might need help, such as prematurity, infection or birth problems.
This could be needed for a few hours or for a number of weeks or months.
There are four ways we help babies with breathing, and we decide how to give this support using clinical observation, x-rays and blood gas analysis.
Ventilators are machines which do the work of breathing for your baby. The doctors insert a small tube (an endotracheal tube) in the mouth down into your baby’s wind pipe. This is secured with a ties and a bonnet. The machine rate and air/oxygen level will be set to your baby’s requirements by doctors and monitored closely.
Nasal prong CPAP (continuous positive airway pressure) is used to assist your baby. The effort of breathing for some babies, especially premature babies, is tiring. CPAP delivers a constant small pressure which helps to keep the lungs expanded. Oxygen is delivered via nasal prongs, which are placed in your baby’s nose and secured by ties and a bonnet.
Vapotherm (high flow therapy) is often used when your baby has weaned off ventilation or CPAP. The vapotherm machine delivers an air/oxygen flow through a cannula in your baby’s nose. The vapotherm prongs are less bulky than CPAP, which makes handling your baby easier, and it’s also more comfortable for your baby. The pressure will be gradually weaned down, which can be days or weeks/months depending on your baby’s requirements.
Nasal prong oxygen is used when your baby does not need pressure support for breathing but does need oxygen. The oxygen is delivered through a cannula in your baby’s nose.