Isolette Practices

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I recently took a staff position after 4 years of traveling and am having some questions regarding isolette practices. I have always been taught that the top should not be "popped" unless it is an emergency situation (intubation, codes, line placement, etc). But, I find a my new job that they practice is to open this isolettes with every assessment, x-ray, etc.

I am looking to see how other people practice. Any articles, policies, etc that people may have regarding this issue.

Thanks!

Nurses that "pop" the top with every assessment are defeating the very reason the baby is in an isolette...all the heat is gone (no, the radiant warmer that automatically comes on does not fully substitute) and if the baby is on humidity, it greatly disturbs that process as well.

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Specializes in CDI Supervisor; Formerly NICU.
I try to dissuade them from even popping when reintubating (if it is a semi-controlled situation). The trays slide out and spin, so the lower half of the baby can remain in the warm environment. I even do tub baths in pink basins with the tops down (even on intubated babies). I admit, I may be a bit of a freak about certain things. (Hey, the first step is owning up to it, right? :-) )
Hilarious to picture you bathing a baby in the isolette and imagining you to look like your avatar.
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Specializes in Level 3 NICU 17 yrs, Neo transport 13 yr.

Our policy is to only pop the top in emergency situations. We too our implementing the "Golden Hour" and try to get all procedures done in that time frame so the top can be closed and the baby be "left alone".

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It depends on the type of patient. If it's a 21 weeker, no one is popping that top off. That baby needs the humidity. Otherwise, it's not seen as a big deal.

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Does anyone have a link to studies or research about keeping the giraffe closes as much as possible vs opening it with each care? In my previous units, we only opened it for emergencies or certain procedures. At my current unit, I see nurses opening it to change a diaper. They also turn on bright lights when they do this and I cringe thinking of the baby's poor brain and eyes. I would love to have some EBP to share with my coworkers to get them to stop this practice.

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WOW. Our unit has a giraffe for every bed space (26) and every infant regardless of gestation and/or acuity is admitted into one, then move to open crib as fluids are DC'd and age permits. I'd love to see a bedbath done with the top down (our older kids all get swaddle baths). Seriously great skills!

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What do you even mean, 21 weeker? I've never seen one alive! Wow.

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It depends on the type of patient. If it's a 21 weeker, no one is popping that top off. That baby needs the humidity. Otherwise, it's not seen as a big deal.

What do you even mean, 21 weeker? I've never seen one alive. Wow.

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I've worked in three NICUs of various levels, and for none of them was it a big deal to open the top. I do it rarely, but I don't think anything about it if it would make it easier to reposition an intubated kid or start an IV or something. And never would we put in a central line or intubate with the top down. There is a heat source, I don't see this as a tragedy if it's open for a bit.

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Specializes in Med Surg, Perinatal, Endoscopy, IVF Lab.

You save 21 weekers?

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