An assessment tool for babies requiring nasal CPAP and high flow

Abstract

Southmead Neonatal Unit is a level 3 tertiary Unit. From 1st January 2013 to 31st April 2014 there were 3112 days of nasal CPAP, of which 353 babies received nasal CPAP via Bubble CPAP using the Fisher and Paykell model, Sipap using the Viasys model or via the Drager model. Nasal CPAP is an effective treatment modality for neonates with RDS and respiratory disease [1]. Nasal CPAP devices have the potential to cause nasal excoriation and scarring if inappropriately applied or infrequently monitored [2]. Care givers providing close observations, i.e. hourly assessment of the infant’s nares have the unique opportunity to identify and assess the infants’ nares [3]. Nurses currently care for babies requiring nasal CPAP work through a CPAP competency. The Practice Development team and the Respiratory team at Southmead have devised a set of guidelines which includes a CPAP competency and a CPAP care plan. In accordance with the Department of Health’s tool kit for High Quality Neonatal Services staff undergo training and achieve these competencies [4]. Each manufacturer provides a tool or template with directions for measuring the baby’s nares and head to determine the appropriate size prongs/ mask and hat. One main challenge is obtaining a well-fitting hat and prongs/mask to maintain airway pressure. The following components need to be examined to