|So what is apnea in infants?
Apnea simply means 'not breathing' and has been expanded into definitions such as those given below:
Apnea - Cessation of respiratory air flow. The respiratory pause may be central or diaphragmatic (i.e. no respiratory effort), obstructive (usually due to upper airway obstruction), or mixed. When short in duration (15 seconds or less) central apnea can be normal at all ages.
Pathological apnea - A respiratory pause is abnormal if it is prolonged (20 seconds or more) or associated with cyanosis (bluish appearance), abrupt marked pallor or hypotonia (limp muscle tone), or bradycardia (heart beat outside expected limits).
Periodic Breathing - A breathing pattern in which there are three or more respiratory pauses of greater than 3 seconds duration with less than 20 seconds of respiration between pauses. Periodic breathing can be a normal event.
Apnea of Prematurity (AOP) - Periodic breathing with Pathological apnea in a premature infant. AOP usually ceases by 37 weeks gestation (menstrual dating), but occasionally persists to several weeks past term.
Asymptomatic Premature Infants - Preterm infants who either never had AOP or whose AOP has resolved.
Symptomatic Premature Infants - Preterm infants who continue to have pathological apnea at the time when they would otherwise be ready for discharge
Apparent Life Threatening Event (ALTE) - an episode that is frightening to the observer and that is characterized by some combination of apnea, color change, marked change in muscle tone (limpness), choking or gagging.
Apnea of Infancy (AOI) - An unexplained episode of cessation of breathing for 20 seconds or longer, or a shorter respiratory pause associated with bradycardia, cyanosis, pallor, and/or marked hypotonia. The terminology "apnea of Infancy" generally refers to infants who are greater than 37 weeks gestational age at the onset of pathological apnea. AOI should be reserved for those infants for whom no specific cause of ALTE can be identified.
Sudden Infantile Death Syndrome (SIDS) - the sudden death of any infant, which is unexplained by history and in which a thorough postmortem examination fails to demonstrate an adequate explanation of cause of death.
Home Infant Monitoring
Your doctor has ordered a home monitor for your baby. This machine will monitor your baby while he/she sleeps. If your baby stops breathing or if there is a change in his/her heart rate, the monitor will alarm. NOTE: This is not a lifesaving device, therefore you should be close enough to respond to any alarm. Parents and or caregivers should complete an infant cardio-pulmonary resuciation (CPR) class.
You will need the following supplies to monitor your baby:
- Apnea monitor
- Lead wires
- Electrode belt
- Every day wash and dry your baby's chest with a mild soap and water. Do not use baby oils, lotions or powders on the electrode sites as these products cause poor conduction.
- Place electrode belt on a flat surface facing up.
- Connect the lead wires to the electrodes. The black lead wire is connected to the electrode that will go on the left side of your baby's chest. The white lead wire is connected to the electrode that will go on the right side.
- Place the electrodes on the belt (smooth side up) with the lead wires facing towards the bottom of the belt. Position the electrodes so that when wrapped around your baby the electrodes will be horizontally in line with the baby's nipples.
- Wrap the belt snugly around your baby. Make sure belt is snug otherwise it will cause false alarms. To test the snugness of the belt, you should only be able to place one finger between the belt and your babys chest.
- Connect the loose ends of lead wires to patient cable that is connected to the monitor.
- Turn monitor on.
Responding to an alarm
You should respond to all alarms.
If the monitor alarms, the following steps should be taken:
- Respond as quick as you can (within 10 seconds).
- Check the baby first. Note the alarm sound, is it a steady alarm or intermittently beeping alarm. A steady alarm indicates a lead or battery problem. A intermittent beeping alarm indicates a baby problem, reffered to as an event.
- If your baby is breathing and his/her color looks good check the electrodes, lead wires and patient cable to determine the cause of a false alarm.
- If your baby's color looks pale or bluish, immediately stimulate your baby. If your baby is still not breathing, shake him or her gently.If your baby's color or heart rate does not return to normal, perform CPR.
NOTE: ANYTIME YOU HAVE HAD TO BREATHE FOR YOUR BABY, IMMEDIATELY TRANSPORT YOUR BABY TO THE NEAREST HOSPITAL.
For more complete instructions on equipment use, refer to the instructions provided by Medox Healthcare.