Mattress filling
1. Check that mattress is filled with coolant (visual inspection/feel for “plumpness”) N.B. where disposable mattresses are used filling will always be required If clearly under filled, attach the mattress to the filling bottle (using both ports) directly and allow the cooling fluid (Sterile Water for Irrigation is suitable for disposable mattresses) to drain into the mattress. Further filling via the machine will be required later to plump up the mattress but this stage speeds that process up: |
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2. Switch on:
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3. Confirm self test The machine will undertake a series of self tests; this will involve audible and visual alarms being displayed. The screen will display the following:
If you have heard two different alarms, seen five symbols on screen and three warning lights press the button below the “Yes”: |
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4. Top up the machine and mattress with coolant Connect the mattress to the unit via the hose:
Place the mattress in an unheated incubator, ensuring that the connecting hoses are not kinked or trapped. Cover the mattress with a thin protective sheet. Select Constant mattress temperature mode:
Then press “start” |
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Fill the coolant filling bottle (With sterile water for Irrigation for disposable mattresses) then attach the green connector to the right hand filling port: Wait until the fluid level stops dropping/bubbles no longer rise |
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5. De-air the internal reservoir/mattress. Attach the other arm of the filling bottle, and wait until bubbles stop rising. At this point, look for bubbles in the mattress and “chase them” round- remember bubbles will rise to the highest point of the mattress. If the bubbles are troublesome try reversing the connections to the mattress, or agitating the mattress to get them out. Once this has been done the mattress should be well filled- plump to feel and curling up at the edges. If that is not the case then repeat steps 4 and 5 again. The mattress is now filled and ready for use. You should now exit the “constant mattress temperature” mode, as follows: select “Option”, then “End treatment and save data |
Starting treatment
1. Select Servo controlled complete treatment mode:
Use the arrows to scroll up and down, then press the button below “Select” |
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2. You will see the following screen:
Press confirm again. |
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3. Select starting temperature and start cooling of mattress You will now see the following screen:
To change any of these options use the arrow keys to scroll down, press select then use the arrow keys again to alter the parameters up or down, and confirm. This will particularly be required for babies coming from outside who have already been cooled for, where the “Duration of Cooling Phase” should be reduced by the number of hours that the baby has been at target temperature. |
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4. Insertion of rectal probe and commencement of cooling of baby. Measure 7cm from the end of the rectal temperature probes and mark with a piece of tape. Insert the tecotherm rectal probe and the probe for the multi-parameter monitor to 6cm (the tape marker should be one centimetre from the anus). Secure with tape to the inner thigh. Connect the tecotherm rectal probe to the machine using the socket marked R (note we now use the disposable probe and adaptor as pictured on the right): The skin probe should be applied to the abdomen (on an area of skin not covered by the mattress) and inserted into the socket marked S. |
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Once probes are in place and connected press the button below “Start” on the screen. You will then see the following screen:
Select Confirm.
Cooling to a target rectal temperature of 33.5oC will now commence. This will be maintained over 72 hours before rewarming at 0.5 oC per hour, as in the TOBY protocol: If the baby’s temperature is outwith 29-39 oC you will see the following screen:
If this is the case select cancel, cancel again, then end the treatment save the data. From the original menu select “Constant Mattress Temperature Probe”, and rewarm or cool the baby to 29-39 oC , setting the mattress temperature manually and monitoring this with the multiparameter monitor.
Once within that range go back to the start menu and select “Servo control complete treatment mode and start again. |
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