The Equipment

One of the markers of success in the NICU is machines that get added or removed from the room. 

In the beginning Barnaby’s room was crowded with equipment. 

When they ruled out seizure activity three large monitoring machines were rolled and he had a dozen less wires coming off of him. 

When he started absorbing oxygen better the noisy jet ventilator was switched to a whisper-quiet traditional one as one machine replaced another. 

When he moved from intubation to CPAP they took away a Transcutaneous oxygen measurement (TCOM or TcPO2) machine that measured carbon dioxide levels in his skin and he had one less sticky pad stuck to him.

Currently he has five real time sensors that monitor him :

1. A temperature sensor that interfaces with his isolette heater to keep his body temperature just right. This is a little silver heart-shaped sticker that is usually right in his armpit
2. Two stickers that read his heart rhythm placed on either side of his chest. 
3. A sticker on his belly that measures his respiratory rate
4. A glowing red spO2 sensor that measures the oxygenation of his blood, this is an important one because it is the best measure of his overall respiratory condition. 
5. The pressure sensor of his respirator. This beeps whenever he claws his vent equipment off of his face which he is constantly attempting to do and occasionally successful at. 

All of these sensors have to get repositioned at care times, the little stickers and pieces of tape get unstuck and re-taped to check the skin underneath.

Another whole cluster of equipment are the IV pumps. Right now he has a PICC line that goes in his ankle and runs a catheter through a large vein to get medicine and fluids into his system. A PICC line is a more long term solution than a normal IV but any access has risk of infection so it’s always a goal to not need it. As soon as his total volume of fluids intake drops below 100 ML per Kilogram they will move intake of whatever he needs (caffeine, nutrition, meds) to P.O. (oral) and remove his PICC line which will remove the IV pumps that are always posted up next to his isolette. 

On the same stand is his Feeding Pump that pushes breast milk into his little orange feeding tube with a set volume per minute.

Also notable is the isolette itself. This $35,000 crib has sensors and fans and heaters and alarms and its own team of mechanics that work in the NICU maintaining it. 

Before he goes home Barnaby will be disconnected from all of this and spend some time in the Growth and Development Unit where babies sleep in normal cribs and do normal baby stuff.