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 Resuscitaire Use: Approach / priorities

© dr.​Chris​R.​Mol,​BME,​NORTEC,​2015​ Resuscitaire
 Apgar score and Apgar timer
The​test​is​generally​done​at​one and five minutes after birth,​and​may​be​repeated​later​if​the​score​is​and​remains​
low.​
• Apgar​scores​7​and​above​are​generally​normal,​
• Apgar​scores​4​to​6​fairly​low,​
• Apgar​scores​3​and​below​are​generally​regarded​as​critically​low.
A​low​score​on​the​one-minute​test​may​show​that​the​neonate​requires​medical​attention​but​does​not​necessarily​
indicate​a​long-term​problem,​particularly​if​the​score​improves​at​the​five-minute​test.​An​Apgar​score​that​remains​
below​3​at​later​times—such​as​10,​15,​or​30​minutes—may​indicate​longer-term​neurological​damage.​
Not​that​the​Apgar​test's​purpose​is​to​determine​quickly​whether​a​new-born​needs​immediate​medical​care.​It​is​
not​designed​to​predict​long​term​health​issues.

An​Apgar Timer will​sound​a​buzzer​for​the​duration​of​3​seconds​at​intervals​of​1, 5, and

10 minutes,​thereby​supporting​the​user​to​take​the​Apgar​scores​at​precise​intervals.​​

© dr.​Chris​R.​Mol,​BME,​NORTEC,​2015​ Resuscitaire
 Components (selection)
The​Bassinet​side​and​front​panels​may​be​folded​down​to​permit​maximum​access​to​the​infant.​The​mattress​
may​be​tilted​up​in​the​rear​at​a​5​or​10​degree​angle.​Openings​are​provided​on​each​side​of​the​bassinet​for​the​
insertion​of​an​(optional)​X-ray​Cassette​Tray.​

The​Controller​controls​all​functions,​including​the​user​interface​control,​the​timing​of​the​pre-heating,​alarms,​
the​Apgar​Timer,​the​Skin​Temperature​probe,​thermostat,​etc.​etc.

The​Blended Gas supply unit mixes​air​and​oxygen,​to​be​used​during​ventilation.​

The​Suction machine, bottle and filter are​needed​to​e.g.​remove​fluids​from​new-born​airways.​

© dr.​Chris​R.​Mol,​BME,​NORTEC,​2015​ Resuscitaire
 Ventilator and
Gas supply
control
(example)

© dr.​Chris​R.​Mol,​BME,​NORTEC,​2015​ Resuscitaire
 Alarms
High Temperature Alarm:​when​skin​temperature​exceeds​39.0​OC​the​heater​is​automatically​turned​
off​and​an​alarm​is​given.​
Probe fail Alarm:​if​the​Skin​Temperature​Probe​fails​(short-circuited​or​open).​
Baby Temperature Alarm:​when​the​temperature​sensed​by​the​Skin​Temperature​Probe​is​1 ​OC​above​
or​1​OC​below​the​selected​Set​Temperature​Display​setting.​
Apgar Timer:​the​timer​will​show​elapsed​minutes​and​seconds​and​the​audible​alarm​will​sound​at​the​
1,​5​and​10​minute​Apgar​time​intervals.​
Power Fail Alarm:​if​the​Power​is​interrupted​while​the​controller​is​on.​
System Fail Alarm:​if​an​internal​malfunction​is​detected;​an​error​code​may​be​displayed.​
Blender Differential Bypass Alarm:​will​sound​when​the​pressure​differential​between​O2​and​Air​
supplies​exceeds​20​psi.​When​this​occurs,​the​blender​will​continue​to​supply​whichever​gas​is​at​the​
higher​pressure:​either​100%​air​or​100%​Oxygen.​

© dr.​Chris​R.​Mol,​BME,​NORTEC,​2015​ Resuscitaire
 Input / Output

Inputs Outputs​
• air • air/oxygen​under​pressure​for​ventilation
• oxygen​ • heat​for​warming
• water • light​
• power​ • suction
• alarms

© dr.​Chris​R.​Mol,​BME,​NORTEC,​2015​ Resuscitaire
 Trouble shooting: temperature measurement
The​temperature probe is​a​frequent​problem.​The​technology​in​the​probe​is​simple;​typically​just​a​
thermistor.​However,​determining​the​exact​type​and​resistance​of​thermistor​requires​data​from​the​
manufacturer.​If​this​data​can​be​obtained,​than​a​replacement​probe​can​be​manufactured​from​a​standard​
thermistor​and​the​proper​connector.​Without​the​manufacturer’s​data,​it​can​be​impossible​to​construct​the​
probe.
A​possible​solution​to​a​missing​thermistor​probe​is​to​place​a​known,​fixed​resistor​in​its​place,​essentially​
forcing​the​device​to​operate​in​manual mode.​A​potentiometer​can​be​used​to​determine​the​value​of​
resistance​that​is​required​to​force​the​lights​to​come​on.

Thermocouple probes are​sometimes​used​on​warming​units,​in​which​case​a​resistance​will​not​substitute​

for​the​probe.​A​voltage​source​might​work,​however.​Using​a​potentiometer,​a​battery​and​a​fixed​resistor,​a​
voltage​divider​can​sometimes​be​created​and​adjusted​until​the​warming​unit​comes​on.​Since​the​device​is​
now​in​manual​mode,​care​should​be​used​to​insure​that​the​patient’s​temperature​is​carefully​monitored.

© dr.​Chris​R.​Mol,​BME,​NORTEC,​2015​ Resuscitaire
 Trouble shooting
The​same​types​of​faults​occur​as​on​anaesthetic​machine:​
• gas​leaks,​
• rotameters​stuck,​
• suction​not​working,​
these​can​be​dealt​with​in​the​same​way​as​described​in​those​sections.​

The​system​needs​to​be​checked​for​electrically​safety​at​least​
once​a​year.

© dr.​Chris​R.​Mol,​BME,​NORTEC,​2015​ Resuscitaire
 END
The​creation​of​this​presentation​was​supported​by​a​grant​from​THET:​
see​​https://www.thet.org/