While there may be additional specialized equipment used to care for your baby in the NICU, this following list should give you a general understanding of some of the machines you may see.
NICU Equipment: Bililights or Bili Blanket
Babies with jaundice are frequently treated by a process called phototherapy. This is done by placing your baby under special bright lights called bililights or by placing your baby on a special bili blanket.
The fluorescent lights are placed over your baby's incubator, whereas the blanket is placed directly under the baby's trunk. A mask or eye patch will be placed over your baby's eyes to assure her comfort and prevent any potential damage from the lights.
The blue light waves from the bililights change the molecular structure of the bilirubin, which allows it to be excreted from your baby's body. If your baby is under phototherapy, she'll be without clothing so as much skin as possible can be exposed to the light. Don't worry, her skin won't burn or be damaged in any way.
While undergoing phototherapy, your baby's bowel movements may be frequent, loose, and may even be greenish in color. Babies also tend to sleep a lot while being treated for jaundice, waking only for feedings.
Phototherapy will be continued, usually for three to seven days, until the bilirubin in your baby's blood is reduced to an appropriate level.
NICU Equipment: Endotracheal Tube
An endotracheal tube is a very small, slender tube which is passed through a baby's nose or mouth, past the vocal cords, and down into the trachea (windpipe). This process may be referred to as intubation.
The tube is attached to a machine (a respirator or ventilator) that pumps air into the lungs, under a controlled pressure, to assist in breathing.
NICU Equipment: Heart Monitor
A heart monitor is the machine used to monitor your baby for signs of apnea and bradycardia.
Small adhesive monitoring pads, referred to as electrodes or patches, are placed on a baby's skin to detect chest movements as she breathes and to pick up the impulses of her heartbeat.
Wires attached to the pads transmit this information to the heart monitor machine next to the baby's bed. If the baby's vital signs become abnormal, an alarm will sound, which alerts the NICU staff.
NICU Equipment: Incubator
An incubator is a heated plastic box that you can see through. It provides a controlled-temperature environment, which helps to keep your baby warm and her body at the correct temperature. As your baby's body varies in temperature, heat may be increased or decreased appropriately.
NICU Equipment: Nasal Prongs
Nasal prongs are used to help your baby breathe during a treatment called Continuous Positive Airway Pressure (CPAP). Through this procedure, pressurized air is delivered to your baby's lungs through small tubes placed inside your baby's nostrils. The tubes provide a steady stream of oxygen. The oxygen may also be delivered at a steady pressure through an endotracheal tube if necessary.
NICU Equipment: Oxygen Hood
An oxygen hood is used for babies who can breathe on their own but still need extra oxygen. Oxygen can be piped directly into the baby's incubator. However, if high or precisely-measured doses of oxygen are required, a plastic box or dome called an oxygen hood, is placed over the baby's head.
Warm, moist, oxygenated air flows into the hood. An oxygen analyzer, placed beside the baby's head, double-checks the amount of oxygen she is receiving.
NICU Equipment: Pulse Oximeter
A pulse oximeter is a portable device that non-invasively monitors and determines a baby's arterial blood oxygen saturation and pulse. It provides a quick and painless method of estimating oxygen delivery to your baby's body tissues. The sensor is usually placed on an extremity, such as your baby's finger or the bottom of her foot.
NICU Equipment: Respirator (Ventilator)
A baby who is having frequent spells of apnea, or is too weak to breathe well on her own, is usually intubated and her endotracheal tube is attached to a respirator. Also referred to as a ventilator, this machine does her breathing for her until she can do it on her own.
The respirator performs several functions:
- It delivers a measured amount of oxygen to the baby's lungs.
- It provides constant baseline pressure to keep the lungs open.
- It inhales for the baby at regular intervals by pushing in additional air at a higher pressure.
The oxygen content of the air, the volume or pressure, and the number of breaths per minute the baby receives can all be adjusted to her needs. The respirator can even be set so the baby triggers her own breaths each time she's ready to breathe.
The NICU staff can determine the baby's needs by observing the baby and by regularly measuring the oxygen, carbon dioxide, and acid levels in the baby's bloodstream.
NICU Equipment: Suction Catheter
A baby on a respirator cannot cough up the mucus that accumulates in her lungs. These secretions must be removed for her, and the NICU staff will probably use a process that includes percussion, vibration and suctioning.
Once the mucus has been loosened by percussion or vibration (there are a variety of methods for both), the baby's endotracheal tube is detached from the respirator. A suctioning tube (or catheter) is quickly inserted into the end of the endotracheal tube to vacuum up any secretions.
NICU Equipment: Warmer
A radiant warmer is a bed designed to try to keep your baby at the right temperature. It is similar to an incubator in its function, but is not enclosed entirely like a box. It is more like a bed with warmth being provided to your baby from a heat source above the bed.
However, as in an incubator, your baby will have a small device, which acts like a thermometer, taped to her body. The device signals for heat to be increased or decreased as needed for your baby.
To help you become familiar with the people caring for your baby, we've listed titles and descriptions of your NICU staff below. (Use this as a general guideline. Your hospital may have fewer or more members on their NICU staff.)
NICU Staff: Neonatologist
A pediatrician (children's doctor) with advanced training in the area of intensive care newborn medicine. You may find that the neonatologist in charge of the NICU unit will change. These doctors may work on a rotating basis. The neonatologist in charge is called the "attending" doctor. Your baby may have one attending doctor during the day and a different one at night.
NICU Staff: Fellow
A fully trained and experienced pediatric (children's) doctor who is training to become a neonatologist.
NICU Staff: Resident
A medical doctor who is specializing in pediatrics (children's medicine). The residents are actively involved in your baby's care and are a good resource for information.
NICU Staff: Neonatal Nurse Practitioner
A nurse who has completed an advanced educational program in neonatology and works under the direction of the neonatologist.
NICU Staff: NICU Nurses
Your baby will have one or more nurses assigned to each shift. Shifts may vary between eight and twelve hours. The nurses try to care for the same babies when they work.
NICU Staff: Primary Nurse
The primary nurse plans your baby's nursing care and is responsible for getting to know you and your baby, and any special needs you may have. The primary nurse's name is often written on your baby's name card which hangs above the crib. This nurse is the nurse most intimately acquainted with your baby's needs and will guide your baby's individualized plan of care.
NICU Staff: Respiratory Therapist
Respiratory therapists are specially trained to care for patients with breathing difficulties. They also are experts on the medical equipment used to treat these types of problems. Respiratory therapists are available in the NICU 24 hours a day. If your baby is having any type of breathing difficulty, you will often see the respiratory therapist at her bedside. They would be happy to answer your questions regarding your baby's lungs.
NICU Staff: Newborn Unit Social Worker
If your hospital has a social worker, you may find them to be a great support for your family. They can also help arrange for housing, transportation and meals; clarify hospital policies and procedures; alert the attending doctor or fellow of your questions and concerns; identify resources such as parent groups, reading materials and computer resources; and assist in planning your baby's follow-up care at the time of discharge. Some hospitals have space that allows a parent to stay with his or her baby. The social worker will explain what accommodations are available so that you can stay as physically close to your baby as possible.
NICU Staff: Other Caregivers
Depending on your baby's needs, she may require the care of other specialized doctors. They will be introduced to you, if necessary for your baby's care. While this may seem like a lot of information to process, you'll soon learn and become comfortable with the NICU routine.
Don't be afraid to ask questions.
The NICU staff is working for you and your baby and is there to help you in any way it can. Remind yourself often that although staying in the NICU isn't what you had envisioned would happen to your baby, it is necessary. This special place exists to help the baby you love.