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The “Buzz” of Stanford Hospital

The “Buzz” of Stanford Hospital. George Brooks, Biomedical Equipment Technician pictured with Juliet Limos, housekeeping primarily equipment walk-through next time: George’s interaction with these products, tour of in-use incubators. Hot Bed.

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The “Buzz” of Stanford Hospital

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  1. The “Buzz” of Stanford Hospital • George Brooks, Biomedical Equipment Technician • pictured with Juliet Limos, housekeeping • primarily equipment walk-through • next time: George’s interaction with these products, tour of in-use incubators Nepal March 6, 2007

  2. Hot Bed • Full-view of the hot bed, similar device to the incubator • Baby goes here after birth/ before transfer to incubator • Heat is the main function here Nepal March 6, 2007

  3. Incubator • Photo of hallway storage • After the incubator has been cleaned, it is wrapped in plastic and stored for future use (hall) • Questions • will we need to facilitate storage through design? • will our facility have enough to rotate in/out? Nepal March 6, 2007

  4. Control Panels • Ohio Care Plus panel: patient temp, air temp, control temp, heater % (humidity?), alarms and indicator light • Hot Bed panel: patient temp, control temp, power %, elapsed time, alarms (probe failure, patient temp, system failure…), light on/off, Apgar tones on/off • Giraffe Upper Panel: >37C, lamp and baby icons 1 2 3 Nepal March 6, 2007

  5. Incubator Mattress • Mattress can be completely removed for cleaning (hot bed example) • Mattress in the State-of-the-Art Incubator, the Giraffe • Mattress and mattress unit is modular, entire incubator can be disassembled • material is “plastic-y” can be wiped down, non-absorbent, soft 3 1 2 Nepal March 6, 2007

  6. Incubator Doors • Doors have holes/ports on both sides so that patient can be accessed from any direction • against wall is not an issue • multiple people can assist patient if needed • Entire door flap can open to change linens • Generally, access points are small to reduce temperature fluctuations, minimize heat loss 2 1 Nepal March 6, 2007

  7. Incubator Tube Access • Ohio Care Plus Access Ports • Giraffe Access Ports • Designed to minimize heat loss: small, close over the tubing, flexible material • Oxygen, ventilation, IV/drugs (things that require outside equipment) pass-through points • Additionally, Giraffe has a tube holder inside of the incubator (looks like a pool stick-assist, not pictured) 1 2 Nepal March 6, 2007

  8. Hot Bed Oxygen, Vent Tubes • Hot Bed tubing equipment (same for incubator because these are external) • Oxygen mask/bag and tubing to the oxygen tank • Ventilation tubes, either down the patient’s throat or into the airway through an external hole 1 2 Nepal March 6, 2007

  9. Incubator Walls, Bed Tilt • Doors are double-walled to prevent fogging in the humid environment (preserve visibility of the patient) • adds to “nooks and crannies” that make these hard to clean! • Bed on the Ohio Care Plus can be tilted to raise the head or the feet if the patient has a certain type of illness (respiratory, for example) 1 2 Nepal March 6, 2007

  10. Incubator Wheels, Lights • Wheels on the Giraffe Incubator are large, must be able to jump elevator cracks because the patient stays with the bed • Lights are shielded to prevent heat transfer to patient or burns to patient care team or visitors, safety against bulb popping 2 1 Nepal March 6, 2007

  11. Heating • Heating element and fan • Space beneath the mattress where the heater/motor/fan sits on the Ohmeda Ohio Care Plus Incubator • “this fan always breaks!” Fan circulates the humid air throughout mattress area 1 2 3 Nepal March 6, 2007

  12. Giraffe Water and Heating • Giraffe Incubator, Water Reservoir (outside) and internal heating design shown, with bed removed, during cleaning • Closer image of the heating fins (black) and the fan (silver) • Giraffe Omnibed is Stanford’s “gold-standard” incubator 3 water filter fan fins 2 1 Nepal March 6, 2007

  13. Giraffe Water Reservoir • Water reservoir provides moisture for a humid environment • Picture with reservoir removed, showing the filter between the water and the heating element/fan • unclear whether air is moving through the filter to pick up moisture or if the water moves through the filter to meet the hot air 2 1 Nepal March 6, 2007

  14. Heating Video, Giraffe Nepal March 6, 2007

  15. Cleaning the Incubator • Juliet uses a scraper and an adhesive remover to get rid of tape gum (this is everywhere!) • She disassembles the doors and soaks them in a cleaning solution • Doors can get very dirty, with blood, hair, dust, tape • Cleaning is critical to patient safety! • Each person who cleans develops their own method • Each incubator can take 1.5 hours to clean • One person to clean each incubator, they pull the entire thing apart • Note: gloves- will Nepal have this or use consistently?, material must be able to withstand harsh chemicals and tape removal devices here 3 2 1 Nepal March 6, 2007

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