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Care of baby under radiant warmer

This slides contain detailed description of radiant warmer used in hospital setting, various modes , alarms, do's and don't of radiant warmer and nursing care management for the baby under radiant warmer

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Care of baby under radiant warmer

  2. 2. INTRODUCTION O The radiant warmer (also called open care system) was developed as an ‘open incubator’ that ensures ready access to the baby. O The overhead quartz heating element produces heat which is reflected by the parabolic reflector on to the baby on the bassinet.
  3. 3. O The quantity of heat produced is displayed in the heater output display panel. Temperature selection knobs select the desired skin temperature. O Radiant warmers provide intense source of radiant heat energy. They also reduce the conductive heat losses by providing a warm microenvironment surrounding the baby.
  5. 5. SERVO MODE O Set temperature at 36.5 C, heater output will adjust automatically to keep baby at set temperature. O If the baby temperature is below the set temperature, the heater output will increase; if the baby is at set temperature or higher the heater output will become zero. O Look for probe displacement when the baby in servo mode every hour. O Servo system is the preferred method of running the open care system.
  6. 6. O In the servo mode, whenever the baby’s temperature rises by more than 0.5°C above the set temperature, a visual/audible alarm is activated. O Caregiver must pay attention to sort out the fault. O Often this occurs when the temperature probe comes off the baby’s skin.
  7. 7. MANNUAL MODE O The heat output from the quartz heating rod could also be increased or decreased manually. O This is done by the heater output control knobs. This is called the manual mode of operation.
  8. 8. O Temperature selection panel :Select either set temperature or skin temperature O Temperature selection knobs :Select a desired set temperature O Temperature display :Display temperature as selected, either of the baby’s skin (via skin probe) or the set temperature O Mode selector :Selects manual or servo mode O Alarm display for power failure, system failure, skin probe failure
  9. 9. STEPS FOR USE OF WARMER 1. Connect the unit to the mains. Switch it on. 2. Once connected to mains, heater output can be regulated by knob on front panel. The output is displayed as % or bars or bulbs 3. Select manual mode. 4. Select heater output to 100% for sometime (20 minutes) to allow quick pre-warming of the bassinet covered with linen.
  10. 10. 4. Select servo mode. 5. Read the temperature on display 6. Select the desired set temperature of baby as 36.5°C. 7. Place the baby on the bassinet.
  11. 11. 8.Connect skin probe to the baby’s abdomen with sticking tape. 9. If the manual mode to be used, select the desired heater output. 10. In the manual mode, record baby’s axillary temperature at 30 minutes and then 2 hourly. 11. Respond to alarm immediately. Identify the fault and rectify it.
  12. 12. 12. Ensure that baby’s head is cover with cap and body with clothes unless indicated to keep naked. 13. Turn the baby frequently 14. Use of cling wrap
  13. 13. ALARMS ON SERVO RADIANT WARMER NO ALARMS IN MANUAL MODE ALARM PROBLEM RESPONSE “POWER ALARM” If the mains power fails Find alternative means for heating if power cannot be fixed(KMC) “SYSTEM ALARM” If there is an error in the electrical/circuit Change WARMER, as it needs repair “SKIN PROBE FAILURE ALARM” If the temperature probe sensor is not connected properly or if it is not functioning Try to re- connect the sensor correctly. If does not work, change it
  14. 14. “ SKIN TEMPERATU RE ALARM HIGH OR LOW” This alarm operates in servo mode only. It sounds when the patient temperature differs from the SET temperature by > 0.5 C Change to manual mode with maximum output if baby is having low temperature and adjust the temperature to try and normalize the baby’s temperature. If baby is having fever, shift to manual mode and set appropriate heater output. Check for signs of infection “HEATER FAILURE” Indicates heater is not working Change warmer, needs repair
  15. 15. APPLICATION OF SKIN PROBE Do’s Don”t 1.Prepare the skin using an alcohol/spirit swab to ensure good adhesion to the skin. 2. Apply probe over the right hypochondriac area in the supine position. 3. Apply probe to the flank in the prone position. 4. Check sensor probe regularly so as to ensue that it is in place. Ensure that skin probe is free of contact with bed. 1. Do not apply to bruised skin. 2. Do not apply clear plastic dressings over probe. 3. Do not use fingernails to remove skin surface probes. 4. Do not reuse disposable probes.
  16. 16. Use of cling wrap to decrease insensible water losses
  17. 17. Potential pitfalls of servo- controlled warmer O In the event of probe getting displaced from baby’s abdominal skin, overheating of the baby will occur because the skin probe depicts air temperature and heater output keeps on increasing till probe temperature matches control temperature. O Also, repeated activation of alarm will occur when baby develops fever. In this situation, it is better to shift to manual mode with least heater output.
  18. 18. Useful tips for use of radiant warmers O Don’t use the warmer in a cold room. It works best when the environmental temperature is above 20°C. O Keeping the warmer where there is lot of air currents reduces its efficiency. O The warmer must be pre-warmed around 20 minutes before the arrival of the baby or till the set temperature is reached with less than 50% of total heater output.
  19. 19. O While using the manual mode in a warmer without a temperature display, record the baby’s temperature regularly, preferably 2 hourly. O The manual mode is used for initial preparation of bed for the baby or when rapid warming of a severely hypothermic baby has to be done. However, this may be hazardous as babies may become overheated. Except in the continuous presence of a nurse who is watching the skin temperature, it is preferable to use the skin probe with the warmer on servo- mode.
  20. 20. DISINFECTING RADIANT WARMER O When the equipment is in use, all approachable external surfaces should be cleaned daily with an antiseptic solution like 2 % bacillocid or gluteraldehyde. O Spirit or other organic solvents must not be used to clean the glass side panels or display panel. O For disinfection of reusable probe, isopropyl alcohol swab should be used.
  21. 21. O Every seventh day, after shifting the baby to another cot, the used equipment should be cleaned thoroughly, first by light detergent solution and then by antiseptic solution. O All detachable assemblies, are to be treated similarly.