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Make Friends with the Monitors When Your Baby is in the NICU

By Dr. Laura Nathanson

Keep an eye on your baby's monitors in the NICU.

Monitors are computers that receive and interpret the signals your child s body is sending out. These signals are delivered as numbers via a lead placed on or in the body, transmitted by a wire to the machine. Most commonly, monitors measure heart and breathing rate, blood pressure (how hard the heart needs to work), and the blood s supply of oxygen. Other monitors measure more special signals: the pressure of the spinal fluid, for instance.

The Settings on a monitor determine at what point the number value of each particular vital sign gets too high or too low, at which point the monitor should alarm. A heart rate over 150, say, or oxygen saturation under 90. These settings vary from individual to individual, depending on age and condition.

Well that s all fine and good, but it doesn t take childhood behavior into account. You may notice, and be alarmed, that when a monitor alarm goes off like a cat with its tail stepped on, it very often doesn t get an instant full team response. Almost always, that s because nurses, no matter how busy, know which children are in a precarious situation and which are not.

But it can work the other way, too. Monitors can t monitor everything -- how a child is feeling, or talking, or behaving, or whether he looks as if he is going to throw up. They also can t announce that even though the numbers are within the range of the settings, there is a sinister trend: say that over an hour the Oxygen Saturation falls from 100 to 93. Clearly, there is something wrong, but the alarm doesn t go off. To spot the trend, somebody s got to be watching the child. That s what nurses used to do, back in the day -- they would get to know their small patients and be alert to such changes. Now it s up to YOU.

So keep your eyes open, and if you think your child s condition is changing for the worse, press the Call Button. If no one comes, get out there in the corridor and snag the next nurse you see. Worse case scenario, blow that whistle.

Dr. Laura Nathanson is the author of What You Don't Know Can Kill You and The Portable Pediatrician, as well as several other books. She has practiced pediatrics for more than thirty years, is board certified in pediatrics and peri-neonatology, and has been consistently listed in The Best Doctors in America. Copyright © 2007 Laura Nathanson


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