Transport Incubator and Ventilator
Contents
1. Document Library Folder Sub Folder Child Health Neonatal Clinical Transport Incubator and ventilator Neonatal Clinical Guideline Page 8 of 8 One all we care Royal Cornwall Hospitals NHS NHS Trust Links to key external standards None Related Documents Individual Instruction manuals Training Need Identified In house training on incubator use Version Control Table Versio Changes Made by Date No summary of Changes Name and Job Title 10 Jun 10 V1 0 Initial Issue Author Jenna Julien Document reviewed by author and approved Staff Nurse by Neonatal Guidelines Group Formatted Formatter Kim Smith Staff Nurse May 2015 V2 0 Please complete all boxes and delete help notes in blue italics including this note All or part of this document can be released under the Freedom of Information Act 2000 This document is to be retained for 10 years from the date of expiry This document is only valid on the day of printing Controlled Document This document has been created following the Royal Cornwall Hospitals NHS Trust Policy on Document Production It should not be altered in any way without the express permission of the author or their Line Manager Transport Incubator and ventilator Neonatal Clinical Guideline Page 8 of 8 Appendix 2 Initial Equality Impact Assessment Form Name of the strategy policy proposal service function2. Sex male female trans x gender gender reassignment Race Ethnic x communities groups Disability x learning disability physical disability sensory impairment and mental health problems Religion x other beliefs Marriage and civil x partnership Pregnancy and maternity X Sexual Orientation X Bisexual Gay heterosexual Lesbian You will need to continue to a full Equality Inpact Assessment if the following have been highlighted e You have ticked Yes in any column above and e No consultation or evidence of there being consultation this excludes any policies which have been identified as not requiring consultation Or e Major service redesign or development 8 Please indicate if a full equality analysis is recommended No 9 If you are not recommending a Full Impact assessment please explain why No area indicated Signature of policy developer lead manager director Date of completion and submission Paul Munyard 07 07 2015 Names and signatures of 1 members carrying out the 2 Screening Assessment Keep one copy and send a copy to the Human Rights Equality and Inclusion Lead c o Royal Cornwall Hospitals NHS Trust Human Resources Department Knowledge Spa Truro Cornwall TR1 3HD A summary of the results will be published on the Trust s web site Signed Kim smith Date 07 07 2015 Transport Incubator and vent
3. is intended for intermittent operation to remove secretions blood or vomit from a patient s airway to allow ventilation The machine should be kept on charge to allow optimum battery time when in use the 4 battery lights will be lit when fully charged The machine has a disposable inner liner and tubing which should be new and in place for every patient or replaced when the canister is full The canister and machine itself can be washed with warm soapy water between uses The machine integral test function should be performed on a daily basis To do this the machine must be set to 500 mmHG whilst holding the TEST button once the 2 light on the battery bar has lit up the suction catheter should be occluded until all 4 battery lights are alight and it returns to 1 light again the machine should then be set back to 0 mmHg If this all occurs the test is complete and the machine safe to use Please refer to user manual for trouble shooting advice Transport Incubator and ventilator Neonatal Clinical Guideline Page 3 of 10 One all we care Royal Cornwall Hospitals NHS NHS Trust 2 6 Propaq Encore Monitor The monitor provides ECG BP and saturation monitoring for the transport of any infant requiring observation The monitor needs to be wiped clean with warm soapy water between uses and on a regular basis and all wires check for damage The monitor must be checked on a daily basis and ensured that it is on charge a green
4. to be assessed hereafter referred to as policy Provide brief description Transport Incubator and Ventilator Neonatal Clinical Guideline Directorate and service area Is this a new or existing Policy Child Health Directorate Neonatal Existing Name of individual completing Telephone assessment 01872 252667 Paul Munyard 1 Policy Aim This guideline is aimed at all staff responsible for using the neonatal Who is the strategy policy proposal service function aimed at transport incubator and ventilator 2 Policy Objectives As above 3 Policy intended Audit Outcomes 4 How will you Audit measure the outcome 5 Who is intended to benefit from the policy All staff involved in the transfer of infants either internally or externally Neonatal patients 6a Is consultation required with the workforce equality groups local interest groups etc around this policy b If yes have these groups been consulted C Please list any groups who have been consulted about this procedure No Neonatal guideline group consultant approved guideline 7 The Impact Please complete the following table Are there concerns that the policy could have differential impact on Equality Strands Yes No Rationale for Assessment Existing Evidence Age x Transport Incubator and ventilator Neonatal Clinical Guideline Page 8 of 8
5. One all we care Royal Cornwall Hospitals NHS NHS Trust TRANSPORT INCUBATOR AND VENTILATOR NEONATAL CLINICAL GUIDELINE 1 Aim Purpose of this Guideline 1 1 This guideline identifies the key equipment and testing requirements needed to ensure that the Neonatal Transport Incubator is safe and fit for use before and after any transfers take place 1 2 The purpose of this document is to outline how to use the transport incubator the importance of a regular systematic checking procedure and a working knowledge of the equipment to ensure safe and effective transfers 1 3 This guideline will need to be acknowledged and followed by all staff that have any dealings with the transport incubator This will include anyone who may be involved with moving the equipment around the hospital and outside of the hospital grounds 2 The Guidance 2 1 Handling and using the incubator platform The incubator platform is made of steel and therefore very heavy when fully loaded Therefore it should always be manoeuvred with at least two members of staff There are handles at each end of the stretcher for when it is moved Please ensure the brakes are off before attempting to move the incubator The platform is equipped to provide intensive care for newborn infants and is configured to run with internal battery and bottled gas or external power and external air and oxygen The platform holds 4 size E gas cylinders 2 for Medical air and 2 fo
6. be secured around the zip and dated and the relevant paperwork signed Please follow the appropriate checklist for equipment required within the bags Transport Incubator and ventilator Neonatal Clinical Guideline Page 4 of 10 One all we care Royal Cornwall Hospitals NHS NHS Trust 3 Monitoring compliance and effectiveness Element to be Key changes in practice monitored Lead Paul Munyard Consultant Paediatrician and Neonatologist Tool Audit To be included in the Neonatal Audit and Clinical audit Programme Findings reported to the Child Health Directorate Audit and Neonatal Clinical Guidelines Meetings Frequency As dictated by audit findings Reporting Child Health Directorate Audit and Neonatal Clinical Guidelines arrangements meetings Acting on Paul Munyard Consultant Paediatrician and Neonatologist recommendations and Lead s Change in Required changes to practice will be identified and actioned within practice and 3 months lessons to be A lead member of the team will be identified to take each change shared forward where appropriate Lessons will be shared with all the relevant stakeholders 4 Equality and Diversity 4 1 This document complies with the Royal Cornwall Hospitals NHS Trust service Equality and Diversity statement 4 2 Equality Impact Assessment The initial Equality impact assessment screening form is at Appendix 2 Use of the neonatal Transport Incubator a
7. ilator Neonatal Clinical Guideline Page 8 of 8 Transport Incubator and ventilator Neonatal Clinical Guideline Page 8 of 8
8. light will be illuminated on the right hand side and that all leads are present clean and that a saturation wrap is present The monitor should also be turned on to check functionality 2 7 Tom Thumb Infant Resuscitator The Tom Thumb resuscitator can deliver up to 15 litres per minute and has a dual flow meter so that infants can be resuscitated in air or variable amounts of oxygen A pressure dial can be altered to provide a variable amount of PEEP as necessary and the visual pressure gauge displays this The resuscitator is compatible with single use T piece circuits and the unit should be cleaned as per hospital policy using detergent wipes The resuscitator should be serviced every 12 months or if the gauge fails to read zero when not in use 2 8 Alaris Intravenous Syringe Drivers The transport unit is able to accommodate 2 Alaris syringe drivers clamped onto an adapted metal pole these can then be plugged into the main bank of plugs They must remain plugged in and on charge when not in use The pump can be used to deliver fluids and drugs via syringes above 5ml using the relevant extension sets Please ensure specific training has been received on general functions and alarms before using the driver in this setting 2 9 Red and Yellow Transport bags These bags should receive a full check for stock and expiry dates once a month and after they have been used Once a check has been performed a plastic cable tie with tag must
9. nd of the incubator is closed properly to avoid air leaks A humidity sponge is available for use Check observation light is functional Ensure that there are a set of restraining straps clean sheet is in place and appropriate bedding available The air filter should be changed every 3 months but should also be regularly checked for dirt build up and changed early if necessary The date of last change should be documented on the filter Please refer to user manual for further information troubleshooting The Incubator should have a thorough clean with hot soapy water every month and after a transfer has taken place Any problems damage faults should be reported and the Nurse in Charge informed 2 3 Fabian Ventilator Fabian neonatal ventilator is an intensive care ventilator for premature babies and neonates The ventilator can provide the following ventilation modes IPPV SIMV SIPPV PSV and CPAP It has an internal rechargeable battery which provides up to 2 hrs operation when no external electricity supply is available therefore it must be plugged in at all times when external electricity is available in order to keep the battery fully charged A new complete disposable ventilator circuit should be connected at all times and the ventilators Exhalation block and Diaphragm letters TOP facing outwards in place to ensure checks can then be carried out appropriately A separate CPAP circuit should also be available for use Trans
10. nd ventilator Clinical Guideline Page 5 of 10 One all we care Royal Cornwall Hospitals NHS NHS Trust Appendix 1 Governance Information Document Title Use of the neonatal transport incubator and ventilator Clinical guideline Date Issued Approved 12 May 2015 Date Valid From 07 July 2015 Date Valid To 07 July 2018 Directorate Department responsible author owner Jenna Julien Staff nurse Contact details 01872 252667 Brief summary of contents Document providing guidance on the use of the neonatal transport incubator and ventilator for internal or external patient transfers Suggested Keywords Neonatal Transport incubator Transfer Target Audience RCHT PCH CFT KCCG v Executive Director responsible for Policy Medical Director Date revised January 2015 This document replaces exact title of previous version New Document Approval route names of committees consultation Neonatal Clinical Guidelines Group Child Health Directorate Audit Consultant approval Divisional Manager confirming approval processes Sheena Wallace Name and Post Title of additional signatories Not Required Signature of Executive Director giving approval Original Copy Signed Publication Location refer to Policy on Policies Approvals and Ratification Intranet Internet amp vA Only Intranet
11. port Incubator and ventilator Neonatal Clinical Guideline Page 2 of 10 One all we care Royal Cornwall Hospitals NHS NHS Trust The ventilator needs to have a basic check performed on a daily basis and before a transfer please refer to the ventilator checklist this includes calibrating the oxygen and flow sensors Cleaning The whole ventilator should be cleaned with detergent wipes between uses the ventilator tubing and flow sensor disposed The exhalation block and membrane should be sent to CSSD and can be done so 25 times or until it is no longer intact 2 4 Fisher Paykel Humidification Unit The humidifier is used to warm and humidify gases delivered to patients requiring mechanical ventilation positive pressure or breathing assistance The unit should be kept clean and dust free and be clamped onto the pole near to the ventilator at all times to ensure that a complete ventilator circuit can be maintained Only bags of sterile water should be used with the humidification circuit The unit should have a new disposable set between every patient the temperature probes and unit itself should be cleaned with warm soapy water between each use and on a regular basis Whilst doing this the probes should also be checked for any damage and replaced if necessary to avoid injury or malfunction 2 5 Laerdal Suction Unit LSU The LSU is portable electrically powered medical suction equipment intended for field and transport use It
12. r Oxygen There are a number of plug sockets 10 in total at either end of the incubator which can be used when on mains or ambulance power supplies however please ensure that the plug extension switches are on and a red light is on the switch The energy converter has 2 leads a red and black lead which needs to be hooked up to the ambulance in order to run off of the ambulances power supply please see the transfer policy for more information on this 2 2 Daily Checks The transport incubator and all related equipment should be checked on a daily basis and before each use The general hygiene of the incubator should be Transport Incubator and ventilator Neonatal Clinical Guideline Page 1 of 10 One all we care Royal Cornwall Hospitals NHS NHS Trust maintained ensuring that it is clean and dust free A separate checklist should be kept with the incubator which can be signed daily once checks are completed The following should be checked daily The incubator temperature is pre set to 36 C and will heat to this temperature when on unless otherwise changed please ensure this is correct in mains and battery mode and ensure the appropriate light is displayed on the front panel Check the power failure alarm disconnect incubator from mains power and slide out battery tray the power failure alarm should sound and controller light display The doors and portholes open and are not damaged in any way The Iris port on the left e
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