Written 25th August 1996



The trauma of having a child in the Neonatal intensive Care Unit (or whatever your hospital calls it) is always great for parents. I feel this is because of two major factors. Firstly the unknown and secondly the uncertainty.

The other day, a tiny baby died in the same unit where our baby is. This is the first thought in the minds of parents. The doctor who introduces parents to the unit usually explains the chances of survival depending on the age of the child and other factors. Here you see the uncertainty.

Alarms continually sound and can cause nervousness, especially when they come from your child?s equipment. Nurses talk about strange drugs and use unfamiliar words. Your baby has more lines than a telephone exchange. This is the unfamiliar.

I have split up this article into sections entitled sounds and smells and equipment and your baby. This is all based on my twelve week stay (so far) and is meant to be personal testimony rather than a technical manual. I however verified details in this article with staff at the hospital. It may help you.

Sounds and Smells
Before my wife gave birth, the midwife took me on a tour of the NICU. The first thing she mentioned was the sounds we could hear. Odd beeps, and electronic alarms and other high pitched noises. It can be intimidating for a new parent. Although I put on a brave face I must admit it that to begin with it was a bit unsettling.

What does the high pitched sound mean coming from the general direction of my son?s crib mean? Why has not a nurse fixed it yet? I learnt there were some very important alarms and others not so important.

Basically, the alarms which are directly connected to the child are the most important. They give an instant indication of how the baby is breathing, his/her heart rate, blood pressure etc. The other alarms may just be telling someone that a drip or the baby?s regular drugs are finished being given.

When many alarms go off at once it makes parents nervous. I have seen the worry on their faces as they stare helplessly at the baby and the source of the sounds. What do they mean? I will go in to the very basic ones under the equipment section of this document.

What can I smell in NICU? Well the one that comes to my mind first is the iodine which is used for sterilising anything that is going in to the baby?s body. I hate the smell. It has a distinct odour that I now associate with intensive care. Even if I smell something similar when I am outside the hospital I immediately imagine myself in the NICU. Strange how the human mind works isn't it?



Karla in the NICU just after Samuel's birth.

Equipment
There may be a screen above the baby (or more than one) showing vital signs of your child. A very important one is the oxygen saturation level in the baby?s blood, especially if they need assistance breathing. The fact that the child has the equipment means that the level needs to be monitored.

The information is collected by a probe attached to the skin. This is then connected to the computer monitor. Obviously if the level falls below a certain level the alarm bell with ring alerting staff to see if there are problems. The acceptable level in the hospital Samuel is in seen as around 90%.

If the level goes consistently below 88% the child may be suffering. Any lower for longer periods of time can mean the baby is really struggling in breathing. This can cause bradycardia?s. (Which is when the heart rate goes down too low and is not good!)

Besides this measure there are various others, such as blood pressure, CO2, breathing rate and heart rate. The heart rate is another that staff keep a close eye on. When the heart rate goes too low the oxygen saturation level in the blood will usually fall with it. Each monitor usually has its own lead to the monitor. You can imagine all the leads and wires that are attached to the poor baby.

Other than leads that measure bodily functions there are IV lines (Intravenous) and arterial lines. (Tubes to administer drugs or take blood). IV lines bring nutrients, glucose etc, depending the baby?s health and if he/she is feeding. These all have to be inserted into the baby?s veins. As well these there may be a long line, which gives nutrients directly to the heart and is inserted a long way in the vein near the heart.

When Samuel was on his peak of drug intake (three antibiotics and three drugs) via IV?s, he had one in each limb and one in his head. This is a very emotionally disturbing sight for a parent I can tell you. The little child looks so helpless. It also is a very discouraging sight if as you just want to hold the baby without all the bits and pieces everywhere.

The next major piece of equipment you will see is a ventilator. This helps the child?s breathing and can also give oxygen if needed. It is adjusted using pressures and oxygen levels etc. Just looking at all the tubes coming out of it is daunting. This piece of equipment is a friend of baby because without it many would die. It is also any enemy as the action of ventilation can case lung damage and mucus build up. All of which can lead to the baby needing more oxygen, longer ventilation and other problems.

There are two types of assistance given by the ventilator. The first is full ventilation, which can force oxygen and air into the lungs making them breath The tube is usually inserted through the nose in to the airway at the branch of the lungs. The second is the significantly nicer one for children with not as serious problems called CPAP. It just gives pressure and oxygen as needed without the tube in the airway. It comprises of two rubber prongs which are inserted in to the nostrils and tied using a cute bonnet The fact that a plastic tube is not down the airway means it does not do the potential damage that a full ventilation can do.

Let us not forget the humidi-crib or "fishbowl" as I call it. This would be the most well known pieces of equipment by the non initiated. One lady asked me if Samuel was in one which I replied yes. She then said confidently "He should be fine then!" Actually it has no magical properties but serves to keeps the child warm, moist and in a controlled environment.

In Conclusion
So there you have it. Many unfamiliar sights, sounds and smells. Equipment galore everywhere you look.

I have only made a quick summary. However just remember the purpose of it all. It keeps your beautiful precious baby alive. Without it they may not have lived.