So what
is apnea in infants? Apnea
simply means 'not breathing' and has been expanded into definitions
such as those given below:
Apnea - Cessation of
respiratory air flow. The respiratory pause may be central or
diaphragmatic (i.e. no respiratory effort), obstructive (usually due
to upper airway obstruction), or mixed. When short in duration (15
seconds or less) central apnea can be normal at all
ages.
Pathological apnea - A
respiratory pause is abnormal if it is prolonged (20
seconds or more) or associated with cyanosis (bluish appearance),
abrupt marked pallor or hypotonia (limp muscle tone), or bradycardia
(heart beat outside expected limits).
Periodic Breathing - A
breathing pattern in which there are three or more respiratory
pauses of greater than 3 seconds duration with less than 20 seconds
of respiration between pauses. Periodic breathing can be a
normal event.
Apnea of Prematurity (AOP)
- Periodic breathing with Pathological apnea in a premature
infant. AOP usually ceases by 37 weeks gestation (menstrual dating),
but occasionally persists to several weeks past term.
Asymptomatic Premature Infants
- Preterm infants who either never had AOP or whose AOP has
resolved.
Symptomatic Premature Infants -
Preterm infants who continue to have pathological apnea at
the time when they would otherwise be ready for discharge
Apparent Life Threatening Event
(ALTE) - an episode that is frightening to the observer and
that is characterized by some combination of apnea, color change,
marked change in muscle tone (limpness), choking or
gagging.
Apnea of Infancy (AOI) - An
unexplained episode of cessation of breathing for 20 seconds or
longer, or a shorter respiratory pause associated with bradycardia,
cyanosis, pallor, and/or marked hypotonia. The terminology "apnea of
Infancy" generally refers to infants who are greater than 37 weeks
gestational age at the onset of pathological apnea. AOI should be
reserved for those infants for whom no specific cause of ALTE can be
identified.
Sudden Infantile Death Syndrome
(SIDS) - the sudden death of any infant, which is
unexplained by history and in which a thorough postmortem
examination fails to demonstrate an adequate explanation of cause of
death.
Home Infant
Monitoring Your doctor
has ordered a home monitor for your baby. This machine will monitor
your baby while he/she sleeps. If your baby stops breathing or if
there is a change in his/her heart rate, the monitor will alarm.
NOTE: This is
not a lifesaving device, therefore you should be close enough to
respond to any alarm.
Parents and or caregivers should complete an infant cardio-pulmonary
resuciation (CPR) class.
You will need the following supplies to
monitor your baby:
- Apnea monitor
- Lead wires
- Electrodes
- Electrode belt
Treatment
procedure:
- Every day wash and dry your baby's
chest with a mild soap and water. Do not use baby oils, lotions or
powders on the electrode sites as these products cause poor
conduction.
- Place electrode belt on a flat surface
facing up.
- Connect the lead wires to the
electrodes. The black lead wire is connected to the electrode that
will go on the left side of your baby's chest. The white lead wire
is connected to the electrode that will go on the right
side.
- Place the electrodes on the belt
(smooth side up) with the lead wires facing towards the bottom of
the belt. Position the electrodes so that when wrapped around your
baby the electrodes will be horizontally in line with the baby's
nipples.
- Wrap the belt snugly around your baby.
Make sure belt is snug otherwise it will cause false alarms. To
test the snugness of the belt, you should only be able to place
one finger between the belt and your babys chest.
- Connect the loose ends of lead wires
to patient cable that is connected to the monitor.
- Turn monitor on.
Responding to an
alarm You should respond
to all alarms.
If the monitor alarms, the following
steps should be taken:
- Respond as quick as you can (within 10
seconds).
- Check the baby first. Note the alarm
sound, is it a steady alarm or intermittently beeping alarm. A
steady alarm indicates a lead or battery problem. A intermittent
beeping alarm indicates a baby problem, reffered to as an
event.
- If your baby is breathing and his/her
color looks good check the electrodes, lead wires and patient
cable to determine the cause of a false alarm.
- If your baby's color looks pale or
bluish, immediately stimulate your baby. If your baby is still not
breathing, shake him or her gently.If your baby's color or heart
rate does not return to normal, perform CPR.
NOTE:
ANYTIME YOU HAVE HAD TO BREATHE FOR YOUR BABY,
IMMEDIATELY TRANSPORT YOUR BABY TO THE NEAREST
HOSPITAL.
For more complete instructions on
equipment use, refer to the instructions provided by Medox
Healthcare. |