Do you use warmer beds?

prmenrs, RN · Oct 5, 2006

Our little level 2 can't afford Giraffes! So we have warmers, Ohmeda "bubbles" (the round incubators, my personal fav--I hate portholes) and, of course, bassinets. Heck, we just got some decent Phillips/Agelent(sp) monitors, but we didn't get enough, so we still use really old Corometrics.

dawngloves, BSN, RN · Oct 5, 2006

so we still use really old Corometrics.

The blue ones??? Heck, I think I was in one when I was born! :lol2:

Gompers, BSN, RN · Oct 5, 2006

I was just reading a post in the ER thread and thought, "Hmmm.. we hardly use warmer beds anymore." Do you?
All of our preemies are directly admitted into an isolette.It's been years since we've had a micro out in the open like that, all covered in plastic wrap. We might use one for a term kid that's vented if all our Giraffes are being used, but we move them ASAP. We also use them for procedures on term kids or kids in cribs.

So you put term kids in isolettes too then?

We can't afford new isolettes so we really don't have a choice. We admit everyone to warmers and then move to isolettes as they become available. If it's a baby under a kilo, we cover the bed with plastic or a head hood and pipe in warm humidified air. We only have four Giraffe isolettes and one Giraffe Omnibed. If we know we're getting a micropreemie and the Omnibed is available, we'll use that. But otherwise it's a warmer to start with and a Giraffe if we have one after lines have been placed. Our docs like them to be on an open bed for umbilical and PCVC insertions, so that's why we only use the Omnibed right off the bat instead of the regular Giraffes.

Other than that, our main source of isolettes is the 20-30 old Airshields we have. They may not be pretty, and they may be as old as I am...but those things take a licking and keep on ticking!

We aren't loving the Giraffes much these days - yes, they're nice for sick preemies with the scale, humidity, extra room, etc. But they are breaking left and right! The plastic is just so cheap, it seems. Disappointed.

dawngloves, BSN, RN · Oct 5, 2006

Yup. We are luckier than I thought. :uhoh21: We put anyone over 32 weeks in an Air Sheild. Less stable,micros, vented kids go into a Giraffe 95% of the time. We've been doing direct admits to a pre warmed isolette for about 5 years. I love the Giraffe with the elevating hood! So much less stress on everyone for intubations, line placement, LPs.

Of course the rule out sepsis term kid goes in a crib unless we are doing an LP, then we plop him on the warmer for that.

prmenrs, RN · Oct 5, 2006

The Corometrics is a monitor, not an incubator. I think they are grey.

The old "bubbles" are great. I hope we never get rid of those. Like I said, I hate portholes.

@ my previous hospital, when we switched to the bubbles (the Ohmeda bed that looks like a barrel), we sent our old incubators to the zoo! It's really weird to go to the nursery in the children's zoo and see some baby chimp or something in the old Airshields--they even still have the decorations I cut out of contact paper and stuck on the doors!

dawngloves, BSN, RN · Oct 5, 2006

How does that open? How do you keep the heat in?

prmenrs, RN · Oct 5, 2006

You grab that horizontal metal @ the bottom of the clear plastic(looks silver in the picture) and roll the top back and down. There are a couple of stops, one about 6" from the bed, the second about 12". If you put the top all the way down, there was a heater you could then pull over the baby to keep him/her warm, but it is not hooked into the "servo", so you can overheat them. There is a bili light you can attach also, but we used the spotlight type. With the top down you can do an LP, put in a line, intubate, whatever. I love them. Unfortunately, they don't make them anymore and haven't in a long time. Apparently, there were/are a few geographic areas in the country where nurseries loved them, but the other 80% or so that didn't like them @ all. Oh, well. The nursery I'm in now has them and they're still working, so I'm happy.

The 2 bars w/a handle between them is how you tilt the bed. You pull the handle and tilt the whole thing to where you want it.

ncnicunurse · Oct 5, 2006

We use the Drager beds, the gel bed and the regular to admit. Then transfer to an isolette. It's a real pain, but that is our protocol.

cathys01 · Oct 6, 2006

The bubble bed looks like a barbeque grill!!!

We use radiant warmers for admissions and vented kids (term to micros). We move up to isolettes as they are more stable and need less intervention, and as they get bigger. They move to open crib when they can maintain temp (duh, I guess that one's obvious!). The big kids will go straight from warmer (for admission) to crib after a few hours and when they're stable.

RainDreamer, BSN, RN · Oct 6, 2006

If it's a micropremie, we admit straight to the giraffes. When L&D alerts our high risk team of an impending micropremie, we'll get a giraffe warmed up (if we have time) and then they take it over to L&D for the delivery and admit into that. All of the giraffes we have are the ones that can raise up, like a radiant warmer .... makes it nice to be able to get lines placed, IVs started, and all the other admit stuff then lower the top and they're all tucked in.

With the bigger premies and other kids, we'll bring them over in a warmed transport isolette, put them under a radiant warmer and then transfer them to an airshield isolette.

Mimi2RN, ASN, RN · Oct 6, 2006

We do the same thing, admit to a radiant warmer, then transfer to an isolette or bassinette. We usually keep babies on warmers when they are intubated, unless they are lucky enough to get our one and only Giraffe. Depending on our census, a big kid could just stay bundled on a warmer that's turned off, until it goes to the stepdown unit.

We have some good HP and Phillips monitors as well as ancient HP's. Supposedly when we get the next generation, they will connect with our new computer charting program. That's supposed to start up early next year.