CARE OF NEW BORN

UNDER RADIANT
WARMER

LECTURER
UCON, RARIDKOT

PRESE NTEE : TfiRUNl

l'dSC.NgG 1* YR
 An understanding of neonatal thermoregulation
led to significant decreases in morbidity and
mortality in neonates, especially sick preterm
infants requiring intensive care.
Since the first incubator used many advances
in design have been made. Nursing is closed
incubators was initially standard practice and
provided reasonable control over the neonate’s
immediate environment. Subsequently, open
care cots incorporating radiant warmers were
introduced to provide easier access to the baby
receiving intensive care.
• Radiant warmer are used to
THE BODY TEMPERATURE OF
maintain
infants. This is best doneNEWBORN
so that the
• Øuic k a nd Easy accessibility
• Easy
. to connect the tubes of ventilated
baby and do procedures .
• Better monitoring specially if baby has
respiratory distress .
• Can be used as resuscitation trolley in the
labor room
• Good for performing procedures.
• Rapid revvarming.
WARMER:
• More insensible water loss .
• Not uniform heating as compared to
closed system .
• More risks of episodes of
hypothermia.
• Increase risk of infection.
• Keep warmer on with 100 % heater
output, once the baby is arrived shift to
servo mode.
• If baby is having fever , move to manual
mode and make heater output minimum .
If the baby continues to be in servo mode
alarm will get activated time and again.
• When rapid warming of hypothermic
baby has to be undertaken do using
MANUAL MODE.
• In Labour room when attending
delivery , the manual mode alarms
every 10 to 15 minutes indicating
the bed is warm and ready .If alarm
is silenced, again it will reactivate
after another 10-15 minutes.
 only. Manual control is not recommended.
• Ensure O2 Air is delivered aI same
temperature normally 36 ° - 36.5°C .
• Ensure alarms are on and functioning.
• Keep warmer away from cold walls,
windows, sunshine.
• To further ł heat loss, dress infant in
bOOtie s, haI and diaper.
• Don not place oily substances on skin-
may burn.
 PRECAUTIONS: FOR SAFTY
OF THE EQUIPMENTS
• Do not use Ehe Warmer in the presence of
flammable anesŁheŁics: a possible explosion hazard
exisŁs under ŁŁiese condiŁions.
• Use cauŁion when rotaŁinp Ehe cabineŁ Ło avoid
damage to the drawers. Always ensure the drawers
are fully closed before ro Ła Łing the cabinet.
• Never oil or grease oxygen equip ment. Oils and
gFease oxidize readily, and in the presence of
oxygen, will burn violenŁly.
• Do not move Łhe warmer by pushing or pulling on
The bed side panels. This act on may lead to Łhe
deter1o ration and breakage of Łhe componen Łs
which form a safeLy barrie around Łhe infanŁ.
 surface. This may block radiant heat and lead to
cooling of the infant.
• Do not place items on top of the heater
assembly Items placed on top of the heater
assembly can fall and injure the patient,
prevent adequate ventilation of the heater
assembly, and may pose a fire hazard.
• Do not perform the Ch eckout Procedures
(Mechanical and Control Unit) while a patient
occ upies the Warmer.
• Inspect all patient connected tubes or wires before
and after moving or tilting the bed. Tilting or
moving the warmer bed up or down can pulì on
tubing or leads connected to the patient. This may
disconnect tubes or leads, restrict gas or liquid
fìow, or move sensors out of position.
• Prolonged exposure to the light emitted by the
observation lamp in this unit may harm the
unprotected eyes of the infant. For safety, cover
the infant s eyes.
• When using intravenous tubing systems for
delivery of blood components Ło paŁ ents
occupying a warmer, shield any Łubing with
• When using a radiant warmer, change
THE PATIENT S DIAPERS FREQUENTLY.
energy causes more rapid urineRADIANT
evaporation, and may lead to inaccurate
urine diagnostic test/ana lysis and
inaccurate weight measurements.
• Ensure that the bedside panels are
locked in position when a patient
occu pies the bed.
• Do not leave the patient unattended
when the side panels are lowered.
 assembly. These surfaces may be hot and a
burn could result.
• Disconnect power to the Warmer and allow
the heater rod to cool before cleaning to
avoid the possibility of a burn.
• Disconnect the wa rmer power cord and
ahow the unit to cool before replacing the
alarm or observation lights.
• AT RISK GROUPS:
Neonates, especially if premature or
I1YŁ9THŁRMLA: MAY
RESULT IN
CONT...
•M DE TE ( 28 — 32 ” C )
•0 Drowsiness
•@ slow, shallow breathing
•0 shrill cry
•& loss of coordination
Confusion
Tach ycard ia
Tachypnoea
Decreased blood
Seizures
• COntrol panel Has a collection of
display and cOntrol features/knObs
• Heater output display Indicates how much is the
heater output.
• Heater output control knobs For increasing or
decreasing the heater output manually
• Temperature selection panel - Select either set
temperature or skin temperature.
• Temperature selection knobs - Select a desired
set temperature.
• Temperature display -Display temperature as
selected, either of the baby's skin (via skin
probe) Or the set temperature.
• Mode selector Selects manu al or servo mode
 SQFOR USE OF RADIANT
WARMER
• 1. Connect the unit to the mains.
Switch it on. 2. Select manual mode.
• 3. Select heater output to 100% for
sometime to allow quick pre-
warming of the bassinet covered
with linen.
• 4. Select servo mode.
• 5. Select the desired sr
of baby as 36.5 C..
 STEPS CONT...
• 6. Place the baby on the bassinet.
• 7. Connect skin probe to the baby's
abdomen with sticking tape.
• 8. If you want the manual mode to
be used, select the desired heater
output.
• 9. In the manual mode, record baby s
axillary temperature at 30 minutes
and then 2 hourly.
• 10. Respond to alarm immediately.
Identify the fault and rectify it
Do's
1. Prepare the skin using an alcohol/spirit swab to
ensure good adhesion to the skin.
2. Apply probe over the right hypochondrium area
in the supine position.
3. Apply probe to the flank in the prone position.
4. Check sensor probe regularl y so as to ensue
that it is in place. Ensure that skin probe is free
of contact with bed.
5. Cover probe with a reflective r:Over pad, if
availabìe (foil covered foam adhesive pad)..
Don ‘t :
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
• When the equipment is in use, all approachable
external surfaces should be cleaned daily with
an antiseptic solution like 2
% bacillocid or gluteraldehyde. Spirit or other
organic solvents must not be used to clean the
glass side panels or display panel. For disinfection
of reusable probe, isopropyl alcohol swab should
be used. Every seventh day, after shifting the
baby to another cot, the used equipment should be
cleaned thoroughly, fìrst by light detergent
solution and then by antiseptic soluŁion. All
detachable assemblies, are to be treated similarly.
• Radiant warmer are used to mainta in the body
temperature of newborn infants. Radiant warmer
result in decreased rate of mortality and morbidity
of newborns but it also increase the insensible water
loss as compare to incubators. Therefore , it may
necessary to increase the calculated fluid
requirement . This may appear to give the use of
incubators an advantage over radiant warmers since
the fluid
requirement does not have to be altered, but
the restrictions of access to the infant nursed I
inside an incubator is a major hindrance in
present- day newborn care.
• To define the term Radiant warmer.
• To explain the advantages and disadvantages
radiantofwarmer.
• To discuss the indica tiOns of radiant warmer.
• To descri be the ti p to use radiant warmer.
• To explain the precautions for ba by under
radiant warmer.
• To discuss the nursing assessment of ba by
under radiant warmer.
*o describe the pa ts of a d ant wa mer.
• *o explain the steps to use radianr warme .
• ^o explain the disinfection of radiant
warmer.