The ABCs of infant cardiorespiratory monitoring
Identifieur interne : 007543 ( Istex/Corpus ); précédent : 007542; suivant : 007544The ABCs of infant cardiorespiratory monitoring
Auteurs : Deborah Gutter ; Linda EspositoSource :
- Home health care management & practice [ 1084-8223 ] ; 1995-11.
English descriptors
- KwdEn :
- Alarm parameter, Alte, Apnea, Apnea center, Apnea team, Caffeine, Cardiorespiratory, Cardiorespiratory monitoring, Discontinuation criteria, Early discharge, Equipment company, False alarms, Guideline, Health care, Health care provider, Heart rate, Home apnea monitoring, Home care, Home health care nurse, Home health care role, Home monitoring, Home visit, Home visits, Individual basis, Infant, Infant care, Infantile apnea, Initial testing, Jersey sids resource center, Loading dose, Medication, Monitoring, Monitoring guidelines, Monitoring site, Multichannel study, National institutes, Normal heart, Oxygen therapy, Parent, Parental, Parents need, Photograph courtesy, Policy holder, Premature infant, Primary care physician, Proper placement, Prospective study, Respiration, Respiration rates, Side effects, Sids, Sids loss, Sudden infant death syndrome, Syndrome, Technical support, Unresolved apnea, Vigorous stimulation.
- Teeft :
- Alarm parameter, Alte, Apnea, Apnea center, Apnea team, Caffeine, Cardiorespiratory, Cardiorespiratory monitoring, Discontinuation criteria, Early discharge, Equipment company, False alarms, Guideline, Health care, Health care provider, Heart rate, Home apnea monitoring, Home care, Home health care nurse, Home health care role, Home monitoring, Home visit, Home visits, Individual basis, Infant, Infant care, Infantile apnea, Initial testing, Jersey sids resource center, Loading dose, Medication, Monitoring, Monitoring guidelines, Monitoring site, Multichannel study, National institutes, Normal heart, Oxygen therapy, Parent, Parental, Parents need, Photograph courtesy, Policy holder, Premature infant, Primary care physician, Proper placement, Prospective study, Respiration, Respiration rates, Side effects, Sids, Sids loss, Sudden infant death syndrome, Syndrome, Technical support, Unresolved apnea, Vigorous stimulation.
Abstract
Home health care needs of the general population have grown rapidly in the past 10 years. Similarly, specific high-risk groups may be discharged earlier from the hospital setting. These groups include the maternal/child population. The home health care nurse has a great responsi bility in caring for the technical needs of the high-risk infant. The following guidelines for the nursing care of the infant on a cardiorespiratory monitor include rationale for monitoring, pos sible treatment plans, and troubleshooting techniques. Parental coping and issues of insurance reimbursement are discussed. The nurse must be familiar with these concepts to assist the monitored infant in reaching his or her established health outcome goals. Key words: apnea, documented monitoring, home care, parental coping, SIDS, sleep study
Url:
DOI: 10.1177/108482239500800110
Links to Exploration step
ISTEX:ECB8B1CFDD6622A7CF216B23FA9D29E6D196FD4BLe document en format XML
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Similarly, specific high-risk groups may be discharged earlier from the hospital setting. These groups include the maternal/child population. The home health care nurse has a great responsi bility in caring for the technical needs of the high-risk infant. The following guidelines for the nursing care of the infant on a cardiorespiratory monitor include rationale for monitoring, pos sible treatment plans, and troubleshooting techniques. Parental coping and issues of insurance reimbursement are discussed. The nurse must be familiar with these concepts to assist the monitored infant in reaching his or her established health outcome goals. 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Similarly, specific high-risk groups may be discharged earlier from the hospital setting. These groups include the maternal/child population. The home health care nurse has a great responsi bility in caring for the technical needs of the high-risk infant. The following guidelines for the nursing care of the infant on a cardiorespiratory monitor include rationale for monitoring, pos sible treatment plans, and troubleshooting techniques. Parental coping and issues of insurance reimbursement are discussed. The nurse must be familiar with these concepts to assist the monitored infant in reaching his or her established health outcome goals. 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Similarly, specific high-risk groups may be discharged earlier from the hospital setting. These groups include the maternal/child population. The home health care nurse has a great responsi bility in caring for the technical needs of the high-risk infant. The following guidelines for the nursing care of the infant on a cardiorespiratory monitor include rationale for monitoring, pos sible treatment plans, and troubleshooting techniques. Parental coping and issues of insurance reimbursement are discussed. The nurse must be familiar with these concepts to assist the monitored infant in reaching his or her established health outcome goals. Key words: apnea, documented monitoring, home care, parental coping, SIDS, sleep study</p></abstract></profileDesc><revisionDesc><change when="1995-11">Published</change></revisionDesc></teiHeader></istex:fulltextTEI><json:item><extension>txt</extension><original>false</original><mimetype>text/plain</mimetype><uri>https://api.istex.fr/document/ECB8B1CFDD6622A7CF216B23FA9D29E6D196FD4B/fulltext/txt</uri></json:item></fulltext><metadata><istex:metadataXml wicri:clean="corpus sage not found" wicri:toSee="no header"><istex:xmlDeclaration>version="1.0" encoding="UTF-8"</istex:xmlDeclaration><istex:docType PUBLIC="-//NLM//DTD Journal Publishing DTD v2.3 20070202//EN" URI="journalpublishing.dtd" name="istex:docType"></istex:docType><istex:document><article article-type="research-article" dtd-version="2.3" xml:lang="EN"><front><journal-meta><journal-id journal-id-type="hwp">sphhc</journal-id><journal-id journal-id-type="publisher-id">HHC</journal-id><journal-title>Home Health Care Management & Practice</journal-title><issn pub-type="ppub">1084-8223</issn><publisher>
<publisher-name>Sage Publications</publisher-name>
<publisher-loc>Sage CA: Thousand Oaks, CA</publisher-loc>
</publisher></journal-meta><article-meta><article-id pub-id-type="doi">10.1177/108482239500800110</article-id><article-id pub-id-type="publisher-id">10.1177_108482239500800110</article-id><article-categories><subj-group subj-group-type="heading"><subject>Articles</subject></subj-group></article-categories><title-group><article-title>The ABCs of infant cardiorespiratory monitoring</article-title></title-group>
<contrib-group><contrib contrib-type="author" xlink:type="simple"><name name-style="western"><surname>Gutter</surname><given-names>Deborah</given-names></name><degrees>RNC, BSN</degrees><aff>Apnea Center St. Peter's Medical Center</aff></contrib></contrib-group>
<contrib-group><contrib contrib-type="author" xlink:type="simple"><name name-style="western"><surname>Esposito</surname><given-names>Linda</given-names></name><degrees>RN, MPH</degrees><aff>New Jersey SIDS Resource Center New Brunswick, New Jersey</aff></contrib></contrib-group>
<pub-date pub-type="ppub"><month>11</month><year>1995</year></pub-date><volume>8</volume><issue>1</issue><fpage>50</fpage><lpage>64</lpage><abstract><p>Home health care needs of the general population have grown rapidly in the past 10 years. Similarly, specific high-risk groups may be discharged earlier from the hospital setting. These groups include the maternal/child population. The home health care nurse has a great responsi bility in caring for the technical needs of the high-risk infant. The following guidelines for the nursing care of the infant on a cardiorespiratory monitor include rationale for monitoring, pos sible treatment plans, and troubleshooting techniques. Parental coping and issues of insurance reimbursement are discussed. The nurse must be familiar with these concepts to assist the monitored infant in reaching his or her established health outcome goals. Key words: <italic>apnea, documented monitoring, home care, parental coping, SIDS, sleep study</italic></p></abstract><custom-meta-wrap><custom-meta xlink:type="simple"><meta-name>sagemeta-type</meta-name><meta-value>Journal Article</meta-value></custom-meta><custom-meta xlink:type="simple"><meta-name>search-text</meta-name><meta-value>50 The ABCs of infant cardiorespiratory monitoring SAGE Publications, Inc.1995DOI: 10.1177/108482239500800110 Deborah Gutter RNC, BSN Apnea Center St. Peter's Medical Center Linda Esposito RN, MPH New Jersey SIDS Resource Center New Brunswick, New Jersey Home health care needs of the general population have grown rapidly in the past 10 years. Similarly, specific high-risk groups may be discharged earlier from the hospital setting. These groups include the maternal/child population. The home health care nurse has a great responsi bility in caring for the technical needs of the high-risk infant. The following guidelines for the nursing care of the infant on a cardiorespiratory monitor include rationale for monitoring, pos sible treatment plans, and troubleshooting techniques. Parental coping and issues of insurance reimbursement are discussed. The nurse must be familiar with these concepts to assist the monitored infant in reaching his or her established health outcome goals. Key words: apnea, documented monitoring, home care, parental coping, SIDS, sleep study CURRENTLY THE FOCUS of health care systems is on cost-effective, early patient discharge and the demand for high-quality, high-technology home care. Given this trend toward early discharge, patients are leaving the hospital setting with complex needs and conditions that may require advanced home health care skills. One population that may be greatly affected by an early discharge is the premature infant. The trend to discharge premature infants at increasingly lower weights places a great deal of responsibility on the home health care nurse for educating and supporting these families. These high-risk infants frequently require follow-up home visits and may be discharged home on cardiorespiratory monitors. Parents who manage the monitoring of their newborn experience a significant level of stress, requiring support from informal (eg, family, friends, and neighbors) and formal (eg, The authors would like to thank Tracy Carbone, MD, Director of St. Peter's Medical Center's Apnea Center, for her support during this project and Mary Brewer, Secretary for the New Jersey SIDS Resource Center, for her participation in editing. JHome Health Care Prac 1995;8(1):50-64 @ 1995 Aspen Publishers, Inc. 63 professional) network systems in the home care environment,.' Recent studies support the fact that without adequate support and communication from the home care professional, compliance with proper monitoring techniques is compromised. 2,3 The two stressful time periods for a monitored family are at the initiation and discontinuation of monitoring.4 Taking this into consideration, the home health care nurse's role in caring for the monitored family is multifaceted. Parents require assistance in developing confidence in the monitor and in their ability to respond appropriately in an emergency. The nurse educates the parents in recognizing potential problems, such as an unsafe environment or an infant experiencing multiple alarms. Parents need frequent reassurance in their ability to care for their infant. The nurse should contact the family within 24 hours after discharge from the hospital. This can be done via telephone or home visit. The immediate postdischarge period may include more frequent visits, then decrease when the parent is more comfortable with the monitor and infant care. When monitoring is discontinued, the parents' ability to cope without the monitor also requires evaluation. It is important to know that recommended monitoring guidelines exist for specific populations. The National Institutes of Health (NIH) has recommended cardiorespiratory monitoring5 for infants with unresolved apnea of prematurity, who require home oxygen therapy, who have tracheostomies, who have had an apparent life-threatening event (ALTE), and for all infants whose families have experienced two sudden infant death syndrome (SIDS) deaths. Monitoring may be considered on an individual basis for families who have experienced one SIDS loss. THE PREMATURE INFANT A premature infant is defined as any infant born at less than or equal to 3 7 weeks' gestation. This population may be discharged home on a cardiorespiratory monitor if they have unresolved apnea of prematurity. This may be discovered while the infant is in the neonatal intensive care unit (NICU) by observation or routine screening. These infants may have episodes during sleep that require stimulation to resume respiration. Some infants may even require medication to help combat these episodes.5,6 ALTE ALTE is an event that appears life threatening to the observer. It is characterized by some combination of apnea, color change, marked change in muscle tone, choking, or gagging. The observer may believe that the infant has died or will die.5 5 The events that require resuscitation or vigorous stimulation are disturbing to the family and health professional. Because of the nature of an ALTE, there may be no physical findings upon initial evaluation. This is another source of frustration for parents, since it is easier to understand ALTE if there is some tangible evidence for the cause of the event. Infants who present with signs and symptoms requiring vigorous stimulation or resuscitation are at a significantly higher risk for death, especially if subsequent spells occur.7 The SIDS sibling SIDS is defined as the sudden, unexpected death of an infant under 1 year of age that remains unexplained after a thorough case investigation, including performance of a complete autopsy, examination of the death scene, and review of 64 the clinical history.8 SIDS accounts for about 35% of postperinatal deaths in the United States.9 The families of a SIDS infant have experienced the loss of a child. Not only has the family had to make the difficult decision to have another child, but they are faced with the prospect of monitoring their subsequent infant. In 1986 the NIH held its conference on infant cardiorespiratory monitoring.5 Their recommendations for siblings of SIDS are as follows. Monitoring is recommended for infants in which the family has experienced two infant losses due to SIDS. For one SIDS death, monitoring is recommended on an individual basis. Literature suggests the risk for a subsequent sibling may be 3.7 to 10/1,000 for a single SIDS death.10,10 The reported incidence in two or more SIDS deaths per family is 180/ 1,000.11 All of this can be very confusing and disheartening for the family who has already experienced one SIDS loss. These families are often on an emotional roller-coaster. Feelings of guilt about the previous event often abound. An issue of reimbursement by insurance companies often complicates the situation. Families who do not fall within the NIH guidelines may, in the opinion of their physician, still require monitoring. The cost of a monitor that is not reimbursed by insurance places an immense financial burden on the family. This can influence the parents' decision for monitor initiation. The infant on oxygen therapy New NICU graduates are likely to be discharged home on oxygen therapy because infants of smaller birthweights are now surviving; at discharge they may be younger and may not be free of supplemental oxygen. Infants discharged with oxygen therapy are sent home with cardiorespiratory monitoring and pulse oximetry. Each infant who is discharged home on oxygen is at risk for hypoxemia, which may result in bradycardia and prolonged apnea. Therefore until supplemental oxygen therapy is no longer necessary, cardiorespiratory monitoring is required. Included among these patients are infants who have artificial airways, the most common of which is the tracheostomy. For these patients, cardiorespiratory monitoring becomes more extensive. Monitoring may not be discontinued until the tracheostomy is removed. The average age can vary between 18 months and 3 years. INITIAL TESTING There are many different approaches to initial testing when cardiorespiratory monitoring is considered. NICUs may have criteria for testing before discharge based upon either gestational age, birth weight, or symptoms. Testing is indicated when an infant has had an episode of prolonged apnea (ie, a pause in breathing equal to or greater than 20 seconds in duration). The following are examples of testing that may be done during the initial testing period. A sleep study, or multichannel study (Fig 1), may be performed. The number of channels depends upon the symptomatology of the patient. A four-channel sleep study will look at electrocardiographic results (ECG), respirations (ie, through transthoracic chest wall impedance), oxygen saturation, and nasal air flow via thermistor. A six-channel sleep study involves adding an esoph- ageal pH probe to evaluate the lower one third of the esophagus for gastroesoph- ageal reflux. The sixth channel comes from the pulse trend on the pulse oximetery recording. Polysomnography, another method of testing, includes con- 65 d CC m 0 b ro U 0 S (U r. P. a) r. r. Cd u X CI) c, 0 "r., 6 Q3 H r4 b0 ;L4 66 tinuous electroencephalographic (EEG) recording for sleep staging.6 A new approach to testing that may be considered is the use of documented monitor recording (Doc Mot) for 1 to 2 weeks before discharge. This records thoracic impedance respiratory signal and heart rate (ECG). It is also helpful to add pulse oximetery to this recording monitor. When an alarm parameter has been exceeded, the event will be recorded on a disk. This type of testing provides information over a longer period of time than a sleep study. Depending upon the results from the disk, there may not be a need to pursue a multichannel study. 12 There are two options to home monitoring. Nondocumented monitoring involves alarms only when a parameter has been violated. This method of monitoring will not give any hard copy of the event. Parental observation is the only indicator of how well the infant is doing. Documented monitoring records heart rate and respirations onto a disk when an alarm parameter has been violated. This information, combined with parental observations, may give a clearer picture about the infant's progress. 13 The need to reevaluate the patient's cardiorespiratory status may occur at some future point while monitoring. Most sleep studies can be done in the home successfully and safely. The key to a successful sleep study is parental cooperation. A parent must be willing to reposition or re- attach probes to the infant if necessary. Most of the testing will occur in the evening and nighttime hours, since that is when most infants sleep for extended periods. Technical support should be no more than a phone call away at this point. A daily event record is registered by the Doc Mot in the home (Fig 2). A Doc Mot records when an alarm parameter that the apnea center or physician has pro- Fig 2. Healthdyne Smart monitor. Photograph courtesy of Healthdyne. grammed into the monitor has been breached. The key to successful and safe monitoring is parents' ability to follow the guidelines of the apnea center or the physician.13 The home health care nurse will collaborate with the apnea center to discuss the protocol and care guidelines for each individual infant. Once the nurse obtains the guideline information, he or she can assess and support the parents' knowledge acquired from the formalized training through the apnea center prior to the infant's discharge. The parents should be able to describe what is abnormal for their baby and to implement the appropriate intervention. Most apnea centers have 24-hour access. This support is available to parents and professionals involved in the infant's care. The monitor will be periodically "downloaded" to evaluate the infant's progress (Fig 3). This information is essential to decide whether to discontinue medication therapy and monitoring. The parent's compliance with the monitoring guidelines are also considered. The downloading process requires a home visit from the equipment company. They will either replace the monitor or place the information on a computer module and clear the memory from the existing monitor. Both procedures should provide information within 24 hours to the apnea center, physicians, and parents. Information can be obtained in less than 24 hours 67 Fig 3. Examples of central apnea associated with bradycardia. if the infant is symptomatic or has had multiple alarms. CRITERIA FOR DISCONTINUATION The question verbalized by every parent is always, "How long does my baby need to stay on the monitor?" Discontinuation criteria of a monitor varies throughout the country. The reason for initiating monitoring must be considered in each infant's case. What is done for the severely premature infant will not be the same as what is done for the ALTE patient. The following discontinuation criteria represent one possible approach that may be taken. ~ Resolution of whatever initiated monitoring must occur. If the patient initially presented as an ALTE, he or she must no longer display episodes. Similarly, with the premature infant, they must no longer display an immaturity in their cardiorespiratory pattern. ~ The infant should handle a stressor 68 Discontinuation criteria of a monitor varies throughout the country. while on the monitor without demonstrating significant apnea or bradycardia. This may come as a cold, immunizations or surgery after discharge. If the infant can handle these events without an increase in significant alarms, then he or she should handle stressors well. . All testing must indicate a lack of "real" episodes for an extended period. This means that there is no evidence of prolonged apnea or bradycardia and that the parents should not have reported any episodes that required vigorous stimulation or resuscitation. Once these criteria have been met, discontinuation of monitoring can be discussed with the family.6 The infant's progress may be followed in any number of ways, depending upon the part of the country the infant lives in and the type of monitor in use. If Doc Mot is in use, then the infant should be followed by an apnea center that can read the event recordings. Most centers will see their patients in a follow-up clinic. This is where a reevaluation and follow-up plan will be formulated. Information should be expressed clearly to both the parents and the pediatrician. The home health care nurse will collaborate with the team in assessing the family for many factors that may suggest poor coping. The infant's clothes should be removed at some part of the evaluation to assess skin integrity around the monitoring site. If weights and measures are not being done as part of the evaluation, then the nurse practitioner or physician examining the infant should assess the monitoring site. This should also be an opportunity to assess the skin for markings that should otherwise not be there. During this process the parents have an opportunity to voice concerns that they may not express over the phone. The home health care nurse can assist in encouraging parents to verbalize their concerns to the apnea team. Parents often rely on individuals other than family members to be sounding boards for their frustrations and concerns. The health care provider can act as an impartial judge in their dilemmas. Monitoring and infant condition may cause distress to families, particularly mothers, which may be manifested by depression, anxiety, and fatigue.4 4 MEDICATIONS Depending upon the infant's condition at the time of discharge, the infant may or may not be discharged home on medications. The most common medication used in premature infants falls under the category of methylxanthines. This can be prescribed in two different forms, aminophylline or caffeine. Aminophylline is the form that the infant is most commonly given while in the NICU. It requires careful monitoring of levels when used in both the hospital and home environment, sometimes as frequently as every 2 weeks. This medication is given to help stimulate the cardiorespiratory system. It acts by virtue of adenosine antagonism. It will produce a general excitation of the central nervous system (CNS) that should keep the infant's cardiorespiratory drive free of any lapses in "memory." The recommended loading dose is 5 to 6 mg/kg. Recommended maintenance doses vary widely; most studies recommend 1.1 to 3.0 mg/kg 8 hours. Blood levels need to be monitored closely depending upon the 69 infant's status. The acceptable therapeutic range is between 10 to 20 gg/ml. Side effects include tachycardia or arrhythmia, diuresis, glucosuria, ketonuria, hyperglycemia, jitteriness, seizures, vomiting, or hemorrhagic gastritis. A thorough history should be taken when the home health care nurse performs the initial assessment of the infant's status. In the ongoing assessment of the infant, if any of these side effects is suspected, the apnea center or physician should be notified immediately. 14 Caffeine is also a methylxanthine used to treat apnea of prematurity. Caffeine is more active on the CNS. Reported side effects include nausea, vomiting, gastric irritation, agitation, tachycardia, and diuresis. Symptoms of overdose include tonic-clonic seizures. Caffeine may be preferable following discharge because of its ease of administration (once-a-day dosing), wider therapeutic range, and decreased need for blood-level monitoring. The loading dose of caffeine citrate (a citrated form of caffeine) is 20 mg/kg. The maintenance dose is 2.5 to 5 mg/kg per day in one dose, usually in the morning hours. Just like theophylline, caffeine is administered based upon weight; therefore as the infant gains weight, the dosage may need to be increased if the infant is experiencing an increase in real events. The levels also need to be followed frequently after initiating the medication and thereafter if the infant experiences a deterioration in status. The acceptable therapeutic range of caffeine for apnea of prematurity is 8 to 14 gg/mL. 14,15 PARENTAL COPING One most disturbing occurrence for the parents is when the monitor alarms. The monitor will produce a hair-raising, heart-stopping screech. Alarms can occur despite the infant's condition and perfect lead placement. The infant may gain weight, have good color, and appear healthy, yet the monitor may keep alarming. Not all alarms are true apnea or bradycardic events; however, each alarm must be treated as if it were. Most centers instruct parents to respond to the alarm by observing the infant and not the monitor. In practicality this may be difficult because at the very least the monitor is a distraction. Health care professionals are trained and develop a formatted way to respond to a given situation; however, it is difficult to ask parents to respond in the same manner. When a monitor alarms, a parent's primary concern is that his or her infant may not be breathing. Requesting that a frightened parent stop and observe the infant may not always be practical during the initial period of monitoring. A parent's first response to an alarm frequently will be to stimulate the infant first and observe last. Parents may be resistant to observing the infant's characteristics first because of the possibility that their infant is not breathing. However, parents need to develop this observation skill so that the apnea team can determine whether the infant is improving. A parent's first assessment must be whether the infant is breathing. If the infant is breathing, the alarm is treated as a technical alarm, and the equipment is checked. If the infant is not breathing, then stimulation must occur. If stimulation is not successful, then the steps for infant cardiopulmonary resuscitation (CPR) must be initiated. One beep of an apnea monitor produces an immense level of anxiety for parents. Parent's confidence in their knowledge and their preparation in responding to alarms are the most effective attributes to combat these fears. Every opportunity for CPR review should be taken.3 An emergency plan 70 should be worked out before the infant comes home. An emergency phone sheet should be posted by the phone where the call to 911 may be made. If there is more than one phone in the home then it should be placed centrally. A "call" list should be devised specifying childcare and other arrangements that would become necessary in the event of an emergency episode. This list is initiated once rescue personnel arrive at the home and are stabilizing the infant. For example, if only one parent is home, there may be the need to arrange for someone to care for the other siblings. There will also be the need to have support available for the parent who has just experienced the episode. The following describes recommended techniques for dealing with alarms classified as technical. The most common form of monitoring is via a belt to which the monitoring patches attach. This is held in place with a velcro fastener. The position of the monitor belt is extremely important. The belt should fit snugly, allowing for one small finger to slide between the belt and the infant's chest (Fig 4). If the belt is not properly applied, it will shift, causing false alarms. Lead wires should be inspected for correct connection to the monitor. Faulty lead wire connections will result in false alarms. Equipment that is damaged will produce false alarms. All wires and cables leading into the monitor should be checked routinely for any fraying or splitting. If this is discovered, the equipment should be replaced immediately. Repositioning the leads may be necessary if alarms persist after the assessment of all lead wires, belt position, and equipment integrity reveal proper placement. A standard procedure is used when the monitor is initiated. One lead is applied on the right side of the body, midaxillary area, in line with the nipple; the other lead is positioned directly opposite. The lead on the right senses respirations; the lead on the left picks up the heart rate. The panel on the front of the monitor is equipped with lights that will flash when the heart rate and respirations are sensed. If the parent is experiencing apnea alarms without finding any evidence of apnea, then the right lead may need repositioning to an area on the chest where there is Fig 4. Proper placement of monitoring belt and leads. 71 more movement. This change in position increases the monitor's ability to sense respirations. If a problem with sensing the heart rate is detected, then the nurse should palpate the brachial pulse while moving the left lead to a position where the monitor senses the infant's heart rate at the same rate as the palpated rate. If all the above outlined trouble-shooting techniques fail to decrease false alarms, it may be necessary to abandon the belt method for adhesive electrodes. These leads are similar to those used in hospitals. They are made of a variety of materials, the most common being paper and adhesive. These should be changed often and the sites rotated to prevent skin irritation. This method of monitoring offers stability for the older, more active infant. Use of these leads may help with monitoring the smaller premature infant who experiences more frequent alarms due to belt migration as well. A GUIDE TO THE HOME VISIT The following is a guide for the health care professional that should be incorporated into the routine home visit. The assessment should involve a multisystem approach involving environmental, psychosocial, physiologic, health behavior, therapeutic regimen compliance, and technical procedure needs. Starting with the largest organ, the skin, much can be discovered. An attempt should be made to plan the visit around a time when the infant is awake. This allows for observation of the infant without disturbing his or her normal routine. The entire chest wall should be observed to evaluate for rashes or irritations that may be caused by the belt or leads. Close evaluation of the skin alerts the nurse to any marks that are not routinely expected. All marks of this nature should be addressed with the par- Reassuring parents of their ability to care for their infant is extremely effective in diminishing anxiety. ent or caregiver as to their origin. Observation of the chest reveals signs of respiratory difficulty retractions. General color is assessed for cyanosis, specifically around the mouth and under the eyes. The nares should be assessed for any evidence of flaring. These observations are remarkable findings and should be reported to the primary care physician. Auscultation of the infant's lungs and heart and respiration rates should be done every visit. Normal lung sounds are clear and equal. Table 1 represents a general range for normal heart and respiration rates. 16,17 An important aspect of the home visit is a comprehensive assessment of the interaction between mother and infant. First-time mothers with limited child care experience may require more assistance from the health care professional. The general health of the infant should be included in the assessment. The visit should not be focused primarily on the apnea monitor. The parents should be questioned by the health care professional regarding feeding, elimination, and activity patterns. Parents are encouraged to Table 1. Normal heart and respiration rates 72 hold their infant (Fig 5). Some first-time parents involved in apnea monitoring may not interact with the infant appropriately. They may avoid holding their infant because the monitor may alarm or the equipment may be in the way. If this pattern of interaction is noticed by the home health care nurse, the parents should be encouraged to hold their infant more often. Age-appropriate activities and toys should be selected by the parents. Parents who appear distant from their infant are a sign that the infant is at risk for developmental delays from the lack of bonding. The home health care nurse's role in addressing the parent's behavior is crucial for the health of the infant. Maternal/child issues require close assessment by the home health care nurse. Fig 5. Mother holding infant. Issues such as maternal/infant bonding, infant care, and maternal anxiety may be affected by monitoring.18,19 Most individuals the nurse encounters do not have any medical caregiving experience or have not been exposed to infant care or to a variation of infant care. Anxiety produced from the infant's condition and monitoring may greatly affect the care of the infant. The home health care nurse needs to assess and address these issues with the family and the team involved with the infant's care. Bathing of the infant is always a fear of the parent. This can be addressed by requiring parents to remove the monitor and belt during the bath. If they are unable to replace the belt after bathing, technical support is only a phone call away. The home health care nurse can help parents by assessing their ability to bathe the infant while the nurse is present. Reassuring parents of their ability to care for their infant is extremely effective in diminishing anxiety. Instructions on medication administration/side effects, alarm response, and CPR should be reviewed periodically with parents. When needed, instructions should be written down simply and clearly for the parents. Families should be encouraged to place a light by the infant's crib, to keep a journal for documenting infant characteristics with alarms, and to have a phone near or within easy access to the crib (Fig 6). Local rescue squad and first responders should be notified of a home with an infant on a monitor. Phone numbers of the apnea center, physician, home health care nurse, equipment company, and emergency medical service (EMS) should be posted to give the family easy access to support/emergency care. Problems assessed by the home health care nurse should be discussed with the team involved in the infant's care (including the parent), and a collaborated approach 73 Fig 6. Monitor shown at proper distance and height. Photograph courtesy of Edentech Corporation. should be made in the planned intervention and outcome expectations. The home health care nurse should evaluate the parent's knowledge and confidence level in infant CPR.3 All individuals who will care for the infant on a monitor must be instructed in CPR. DOCUMENTATION Table 2 represents an example of a nursing care plan for an infant on a monitor using the Omaha Classification Model. Variations of this care plan will be required, depending upon the reason the infant is on a monitor. Goals are evaluated at the designated time, and results are documented in the outcome column. INSURANCE REIMBURSEMENT Cardiorespiratory monitoring and follow-up care is a costly venture for most families. The last thing most parents are focused on when faced with a sick infant is insurance. However, this can be a costly mistake. With most insurance carriers there are rules that must be followed exactly. If they are not, the family may end up paying large sums of money. There are two types of insurance plans available today, each of which is usually dictated by the parent's employer. The traditional plan is usually the one with the least amount of restrictions and rules. These plans are more costly to the purchaser and require the holder to be re- 74 0 2 P. (D F-4 cd U 00 9 run N C 's 4i 0 0 (D T=! 0 r. 0 % cd u 14.. m M co C Cd ~E., CO 6 0 N a) 3 co E-4 75 sponsible for some of the bill. The advantage of this type of plan is that the policy holder is free to pick whom he or she chooses for medical care. The second type of plan is the health maintenance organization (HMO). This plan was devised primarily to provide preventive health care. The cost to the policy holder is small for routine health care provided within the HMO's network of providers. If care is provided outside the network, a careful check of the guidelines for payment is advised. First, if medical necessity is determined, the HMO must be contacted by a physician's office. The equipment would be arranged through a preferred provider. This is a company that has contracted with the HMO to provide a service for the fee the HMO wishes to pay. If the equipment is obtained outside the network, then the family becomes responsible for the cost above that which the HMO is willing to pay. Second, any further testing, such as an event recording, must be approved by the HMO before it can be done. This also requires phone calls from the apnea center or primary physician's office. All follow-up care that is not provided by the primary care physician (pediatrician) must be preauthorized by the HMO. This will come as a referral from the pediatrician. If parents are not sure of the type of coverage they have or what the rules are, it is advisable for them to call the customer service number of their insurance company. The health care provider can assess the parents' knowledge of their insurance regulations by simply asking what type of insurance plan they have and what it pays for. ... The health care professional's most valuable skill is the ability to listen. Often parents seek out the home health care nurse to verbalize their thoughts and 7664 anxieties. The stress of home monitoring can obscure the real issues involving the pressures of parenting. Covert issues may be detected just by listening. Families who experience a health care crisis are at risk for becoming overwhelmed by every aspect of their lives. Relationships on every level may be strained. The role of the home health care nurse in coordinating and providing care to the high-risk monitored infant is fundamental to a successful, perinatal, home care program. This role can be an efficient method of health care delivery. The cause of major obstacles to rendering care to a monitored family may become known as a lack of knowledge regarding the plan of care or a misinterpretation of the given instructions. The home health care nurse can reinforce while assessing the understanding and family follow-through of instructions given. It is essential that the home health care nurse become competent with cardiorespiratory monitoring and the required treatment plan before making home visits to this population. Working in concert with the physician, apnea monitoring team, community resources, and family, the nurse can provide high- quality health care. This collaboration will ensure a positive health outcome for the infant and family. REFERENCES Nuttall P. Maternal responses to home apnea monitoring of infants. Nurs Res. 1988;37:354-357. Ahmann E., Meny R., Fink R. Use of home apnea monitors. J Obstet Gynecol Neonat Nurs. 1992;21:394-399. Komelasky AL The effect of home nursing visits on parental anxiety and CPR knowledge retention of parents of apnea-monitored infants . J Pediatr Nurs. 1990;5:387-392. Wasserman A. A prospective study of the impact of home monitoring on the family. Pediatrics. 1984;74(3):323-329. Infantile Apnea and Home Monitoring. National Institutes of Health Consensus Development Conference Statement. Pediatrics . 1986; 79:229-292. Kelly D., Shannon D. The medical management of cardiorespiratory monitoring in infantile apnea . In Culbertson JL, Krons HF, Bendell RD, eds. Sudden Infant Death Syndrome: Medical Aspects and Psychological Management . Baltimore, Md: The Johns Hopkins University Press; 1989. Oren J., Kelly DH, Shannon D. Identification of a high-risk group for sudden infant death syndrome among infants who were resuscitated for sleep apnea. Pediatrics. 1986;77:495-499. Zylke JW Sudden infant death syndrome: resurgent research offers hope. JAMA. 1989;262: 1565-1566. Carroll J., Loughlin G. Sudden infant death syndrome. Pediatr Rev. 1993;14(3):83-93. Carbone M. Sudden infant death syndrome in subsequent siblings. New Jersey Medicine. 1992;89:684-686. Oren J., Kelly DH, Shannon D. Familial occurrence of sudden infant death syndrome and apnea of infancy . Pediatrics. 1987;80:355-358. Hunt CE Sudden infant death syndrome and apnea of infancy. Semin Respir Med. 1990;11:165-175. Clinical perspective: The need for documented infant home apnea monitoring. Health Dev. 1992;21(10):339-341. Bhatt D., Reber D., Wirtschafter D., Parikh A., Thomas J. Neonatal Drug Formulary. 3rd ed. Los Angeles, Calif: NDF; 1993. Anwar M., Mondestin H., Mojica N., et al. Effect of caffeine on pneumogram and apnoea of infancy. Arch Dis Childhood. 1986;61:891-895. 16. Wolkenheim BJ Milestones: Growth and Developmental Guide (2nd ed.). Chicago, Ill: Maxishare ; 1994. Beachy P., Deacen J., Witt P. Physical Assessment of the New Born. Core Curriculum for Neonatal Intensive Care Nursing. Philadelphia, Pa: Saunders; 1993. McElroy E., Steinschneider A., Weinstein S. Emotional and health impact of home monitoring on mothers: A controlled prospective study. Pediatrics. 1986;78:780-786. Phipps S., Drotar D., Joseph C., Geiss C., Doershuk C. Psychological impact of home apnea monitoring: Temporal effects, family resources, and maternal coping style. Dev Behav Pediatr. 1989;10:7-12. Guntheroth W., Lohman R., Spiers P. Risk of sudden infant death syndrome in subsequent siblings. J Pediatr. 1990;116:520-524.</meta-value></custom-meta></custom-meta-wrap></article-meta></front><back><ref-list>
<ref>
<citation citation-type="journal" xlink:type="simple">
<name name-style="western"><surname>Nuttall P.</surname></name>
<article-title>Maternal responses to home apnea monitoring of infants</article-title>. <source>Nurs Res.</source>
<year>1988</year>;<volume>37</volume>:<fpage>354</fpage>-<lpage>357</lpage>.</citation>
</ref>
<ref>
<citation citation-type="journal" xlink:type="simple">
<name name-style="western"><surname>Ahmann E.</surname></name>, <name name-style="western"><surname>Meny R.</surname></name>, <name name-style="western"><surname>Fink R.</surname></name>
<article-title>Use of home apnea monitors</article-title>. <source>J Obstet Gynecol Neonat Nurs.</source>
<year>1992</year>;<volume>21</volume>:<fpage>394</fpage>-<lpage>399</lpage>.</citation>
</ref>
<ref>
<citation citation-type="journal" xlink:type="simple">
<name name-style="western"><surname>Komelasky AL</surname></name>
<article-title>The effect of home nursing visits on parental anxiety and CPR knowledge retention of parents of apnea-monitored infants</article-title> . <source>J Pediatr Nurs.</source>
<year>1990</year>;<volume>5</volume>:<fpage>387</fpage>-<lpage>392</lpage>.</citation>
</ref>
<ref>
<citation citation-type="journal" xlink:type="simple">
<name name-style="western"><surname>Wasserman A.</surname></name>
<article-title>A prospective study of the impact of home monitoring on the family</article-title>. <source>Pediatrics.</source>
<year>1984</year>;<volume>74</volume>(<issue>3</issue>):<fpage>323</fpage>-<lpage>329</lpage>.</citation>
</ref>
<ref>
<citation citation-type="journal" xlink:type="simple">
<article-title>Infantile Apnea and Home Monitoring. National Institutes of Health Consensus Development Conference Statement</article-title>. <source>Pediatrics</source> . <year>1986</year>; <volume>79</volume>:<fpage>229</fpage>-<lpage>292</lpage>.</citation>
</ref>
<ref>
<citation citation-type="book" xlink:type="simple">
<name name-style="western"><surname>Kelly D.</surname></name>, <name name-style="western"><surname>Shannon D.</surname></name>
<source>The medical management of cardiorespiratory monitoring in infantile apnea</source> . In <name name-style="western"><surname>Culbertson JL</surname></name>, <name name-style="western"><surname>Krons HF</surname></name>, <name name-style="western"><surname>Bendell RD</surname></name>, eds. <source>Sudden Infant Death Syndrome: Medical Aspects and Psychological Management</source> . <publisher-loc>Baltimore, Md</publisher-loc>: <publisher-name>The Johns Hopkins University Press</publisher-name>; <year>1989</year>.</citation>
</ref>
<ref>
<citation citation-type="journal" xlink:type="simple">
<name name-style="western"><surname>Oren J.</surname></name>, <name name-style="western"><surname>Kelly DH</surname></name>, <name name-style="western"><surname>Shannon D.</surname></name>
<article-title>Identification of a high-risk group for sudden infant death syndrome among infants who were resuscitated for sleep apnea</article-title>. <source>Pediatrics.</source>
<year>1986</year>;<volume>77</volume>:<fpage>495</fpage>-<lpage>499</lpage>.</citation>
</ref>
<ref>
<citation citation-type="journal" xlink:type="simple">
<name name-style="western"><surname>Zylke JW</surname></name>
<article-title>Sudden infant death syndrome: resurgent research offers hope</article-title>. <source>JAMA.</source>
<year>1989</year>;<volume>262</volume>: <fpage>1565</fpage>-<lpage>1566</lpage>.</citation>
</ref>
<ref>
<citation citation-type="journal" xlink:type="simple">
<name name-style="western"><surname>Carroll J.</surname></name>, <name name-style="western"><surname>Loughlin G.</surname></name>
<article-title>Sudden infant death syndrome</article-title>. <source>Pediatr Rev.</source>
<year>1993</year>;<volume>14</volume>(<issue>3</issue>):<fpage>83</fpage>-<lpage>93</lpage>.</citation>
</ref>
<ref>
<citation citation-type="journal" xlink:type="simple">
<name name-style="western"><surname>Carbone M.</surname></name>
<article-title>Sudden infant death syndrome in subsequent siblings</article-title>. <source>New Jersey Medicine.</source>
<year>1992</year>;<volume>89</volume>:<fpage>684</fpage>-<lpage>686</lpage>.</citation>
</ref>
<ref>
<citation citation-type="journal" xlink:type="simple">
<name name-style="western"><surname>Oren J.</surname></name>, <name name-style="western"><surname>Kelly DH</surname></name>, <name name-style="western"><surname>Shannon D.</surname></name>
<article-title>Familial occurrence of sudden infant death syndrome and apnea of infancy</article-title> . <source>Pediatrics.</source>
<year>1987</year>;<volume>80</volume>:<fpage>355</fpage>-<lpage>358</lpage>.</citation>
</ref>
<ref>
<citation citation-type="journal" xlink:type="simple">
<name name-style="western"><surname>Hunt CE</surname></name>
<article-title>Sudden infant death syndrome and apnea of infancy</article-title>. <source>Semin Respir Med.</source>
<year>1990</year>;<volume>11</volume>:<fpage>165</fpage>-<lpage>175</lpage>.</citation>
</ref>
<ref>
<citation citation-type="journal" xlink:type="simple">
<article-title>Clinical perspective: The need for documented infant home apnea monitoring</article-title>. <source>Health Dev.</source>
<year>1992</year>;<volume>21</volume>(<issue>10</issue>):<fpage>339</fpage>-<lpage>341</lpage>.</citation>
</ref>
<ref>
<citation citation-type="book" xlink:type="simple">
<name name-style="western"><surname>Bhatt D.</surname></name>, <name name-style="western"><surname>Reber D.</surname></name>, <name name-style="western"><surname>Wirtschafter D.</surname></name>, <name name-style="western"><surname>Parikh A.</surname></name>, <name name-style="western"><surname>Thomas J.</surname></name>
<source>Neonatal Drug Formulary</source>. <edition>3</edition>rd ed. <publisher-loc>Los Angeles, Calif</publisher-loc>: <publisher-name>NDF</publisher-name>; <year>1993</year>.</citation>
</ref>
<ref>
<citation citation-type="journal" xlink:type="simple">
<name name-style="western"><surname>Anwar M.</surname></name>, <name name-style="western"><surname>Mondestin H.</surname></name>, <name name-style="western"><surname>Mojica N.</surname></name>, et al. <article-title>Effect of caffeine on pneumogram and apnoea of infancy</article-title>. <source>Arch Dis Childhood.</source>
<year>1986</year>;<volume>61</volume>:<fpage>891</fpage>-<lpage>895</lpage>. 16. <name name-style="western"><surname>Wolkenheim BJ</surname></name>
<article-title>Milestones: Growth and Developmental Guide</article-title> (<edition>2</edition>nd ed.). <publisher-loc>Chicago, Ill</publisher-loc>: <publisher-name>Maxishare</publisher-name> ; <year>1994</year>.</citation>
</ref>
<ref>
<citation citation-type="book" xlink:type="simple">
<name name-style="western"><surname>Beachy P.</surname></name>, <name name-style="western"><surname>Deacen J.</surname></name>, <name name-style="western"><surname>Witt P.</surname></name>
<source>Physical Assessment of the New Born. Core Curriculum for Neonatal Intensive Care Nursing</source>. <publisher-loc>Philadelphia, Pa</publisher-loc>: <publisher-name>Saunders</publisher-name>; <year>1993</year>.</citation>
</ref>
<ref>
<citation citation-type="journal" xlink:type="simple">
<name name-style="western"><surname>McElroy E.</surname></name>, <name name-style="western"><surname>Steinschneider A.</surname></name>, <name name-style="western"><surname>Weinstein S.</surname></name>
<article-title>Emotional and health impact of home monitoring on mothers: A controlled prospective study</article-title>. <source>Pediatrics.</source>
<year>1986</year>;<volume>78</volume>:<fpage>780</fpage>-<lpage>786</lpage>.</citation>
</ref>
<ref>
<citation citation-type="journal" xlink:type="simple">
<name name-style="western"><surname>Phipps S.</surname></name>, <name name-style="western"><surname>Drotar D.</surname></name>, <name name-style="western"><surname>Joseph C.</surname></name>, <name name-style="western"><surname>Geiss C.</surname></name>, <name name-style="western"><surname>Doershuk C.</surname></name>
<article-title>Psychological impact of home apnea monitoring: Temporal effects, family resources, and maternal coping style</article-title>. <source>Dev Behav Pediatr.</source>
<year>1989</year>;<volume>10</volume>:<fpage>7</fpage>-<lpage>12</lpage>.</citation>
</ref>
<ref>
<citation citation-type="journal" xlink:type="simple">
<name name-style="western"><surname>Guntheroth W.</surname></name>, <name name-style="western"><surname>Lohman R.</surname></name>, <name name-style="western"><surname>Spiers P.</surname></name>
<article-title>Risk of sudden infant death syndrome in subsequent siblings</article-title>. <source>J Pediatr.</source>
<year>1990</year>;<volume>116</volume>:<fpage>520</fpage>-<lpage>524</lpage>.</citation>
</ref>
</ref-list></back></article></istex:document></istex:metadataXml><mods version="3.6"><titleInfo lang="en"><title>The ABCs of infant cardiorespiratory monitoring</title></titleInfo><titleInfo type="alternative" lang="en" contentType="CDATA"><title>The ABCs of infant cardiorespiratory monitoring</title></titleInfo><name type="personal"><namePart type="given">Deborah</namePart><namePart type="family">Gutter</namePart><namePart type="termsOfAddress">RNC, BSN</namePart><affiliation>Apnea Center St. Peter's Medical Center</affiliation></name><name type="personal"><namePart type="given">Linda</namePart><namePart type="family">Esposito</namePart><namePart type="termsOfAddress">RN, MPH</namePart><affiliation>New Jersey SIDS Resource Center New Brunswick, New Jersey</affiliation></name><typeOfResource>text</typeOfResource><genre type="research-article" displayLabel="research-article" authority="ISTEX" authorityURI="https://content-type.data.istex.fr" valueURI="https://content-type.data.istex.fr/ark:/67375/XTP-1JC4F85T-7">research-article</genre><originInfo><publisher>Sage Publications</publisher><place><placeTerm type="text">Sage CA: Thousand Oaks, CA</placeTerm></place><dateIssued encoding="w3cdtf">1995-11</dateIssued><copyrightDate encoding="w3cdtf">1995</copyrightDate></originInfo><language><languageTerm type="code" authority="iso639-2b">eng</languageTerm><languageTerm type="code" authority="rfc3066">en</languageTerm></language><abstract lang="en">Home health care needs of the general population have grown rapidly in the past 10 years. Similarly, specific high-risk groups may be discharged earlier from the hospital setting. These groups include the maternal/child population. The home health care nurse has a great responsi bility in caring for the technical needs of the high-risk infant. The following guidelines for the nursing care of the infant on a cardiorespiratory monitor include rationale for monitoring, pos sible treatment plans, and troubleshooting techniques. Parental coping and issues of insurance reimbursement are discussed. The nurse must be familiar with these concepts to assist the monitored infant in reaching his or her established health outcome goals. Key words: apnea, documented monitoring, home care, parental coping, SIDS, sleep study</abstract><relatedItem type="host"><titleInfo><title>Home health care management & practice</title></titleInfo><genre type="journal" authority="ISTEX" authorityURI="https://publication-type.data.istex.fr" valueURI="https://publication-type.data.istex.fr/ark:/67375/JMC-0GLKJH51-B">journal</genre><identifier type="ISSN">1084-8223</identifier><identifier type="eISSN">1552-6739</identifier><identifier type="PublisherID">HHC</identifier><identifier type="PublisherID-hwp">sphhc</identifier><part><date>1995</date><detail type="volume"><caption>vol.</caption><number>8</number></detail><detail type="issue"><caption>no.</caption><number>1</number></detail><extent unit="pages"><start>50</start><end>64</end></extent></part></relatedItem><identifier type="istex">ECB8B1CFDD6622A7CF216B23FA9D29E6D196FD4B</identifier><identifier type="ark">ark:/67375/M70-BK8PJL44-M</identifier><identifier type="DOI">10.1177/108482239500800110</identifier><identifier type="ArticleID">10.1177_108482239500800110</identifier><recordInfo><recordContentSource authority="ISTEX" authorityURI="https://loaded-corpus.data.istex.fr" valueURI="https://loaded-corpus.data.istex.fr/ark:/67375/XBH-0J1N7DQT-B">sage</recordContentSource></recordInfo></mods><json:item><extension>json</extension><original>false</original><mimetype>application/json</mimetype><uri>https://api.istex.fr/document/ECB8B1CFDD6622A7CF216B23FA9D29E6D196FD4B/metadata/json</uri></json:item></metadata><serie></serie></istex></record>Pour manipuler ce document sous Unix (Dilib)
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