Neonatologists use a variety of instruments to monitor and care for babies. Pulse oximeters (small tubes with light sensors that measure oxygen saturation) and blood pressure monitors are among them.

Stethoscopes

Stethoscopes are essential to neonatology instruments, allowing healthcare providers to auscultate and monitor newborns’ heart, lung, and bowel sounds. Neonatal stethoscopes are specifically designed for infants of smaller sizes. They are typically dual-headed and have smaller chest pieces to accurately capture and amplify the sounds of the neonate’s body. These stethoscopes are crucial for assessing newborns’ respiratory and cardiovascular health, making them a fundamental tool in neonatal care. In neonatal care, stethoscopes are included in the supply and equipment checklist for various procedures, such as resuscitation preparation and catheter placement. They are listed alongside other essential instruments like bulb syringes, umbilical line trays, pulse oximeter probes, and endotracheal tubes, emphasizing their importance in the neonatal clinical setting. The use of stethoscopes in neonatology is also highlighted in national guidelines for delivery room management, where they are recommended for routine care immediately after delivery. The guidelines specify the need for a stethoscope with a drum for newborns, underlining the significance of this instrument in the initial assessment and stabilization of neonates.

Blood Pressure Monitors

Monitoring the blood pressure of neonates is essential in neonatal critical care, especially for premature infants who have a higher risk of morbidity and mortality compared to full-term babies. Hypotension is a common issue among premature babies and can be caused by various factors such as blood loss, an immature cardiovascular system, patent ductus arteriosus, mechanical ventilation, and more. Therefore, proper blood pressure monitoring is essential for neonates’ well-being.

The top number in a blood pressure reading measures the force exerted against the artery walls when the heart contracts. The bottom measurement is taken when the heart relaxes. Manual meters, such as stethoscopes and aneroid sphygmomanometers, are commonly used, but they require calibration and are prone to errors caused by jarring, edema, and patient limb movement. Therefore, there is a need for a wearable continuous non-invasive blood pressure (cNIBP) device for premature neonates.

Oximeters

Pulse oximeters are simple, safe devices that measure oxygen saturation levels in the skin. They consist of a small light emitter and detector applied to the fingertip or other body site. Before use, the fingertip should be free of nail polish or other pigmentation that could obstruct the light. The probe should also fit the digit well without restricting circulation. There are various other sensor sites, including the earlobe and toe.

Oximetry has become a critical part of neonatal care. However, it is essential to be aware of the limitations and risk of inaccuracies of pulse oximetry. Inaccurate measurements may lead to unrecognized low oxygen saturations. Additionally, racial differences in the performance of oximeters may result in occult hypoxemia in Black preterm infants.

Temperature Probes

Infrared thermography is a non-invasive method of obtaining neonate skin temperature measurements. It enables accurate visualization of a neonate’s surface temperature distribution, which is crucial for assessing thermoregulatory reflexes and incubator/radiant warmer functioning.

In contrast to rectal thermometers, NIRT imaging and measurement can be done without touching the infant. This may help prevent infection due to bacterial contamination of disinfected or stored rectal thermometers.

Furthermore, it is reported to cause less disturbance than axillary temperature measurement regarding behavioral state, pain profiles, heart rate variation, and partial oxygen saturation. This could help monitor neonates at risk for hypothermia.

Other Instruments

The NICU depends heavily on advanced biomedical devices for monitoring, diagnosis, and treatment. However, these devices are frequently miniaturized versions of products developed for use in older patients or adults and have yet to undergo rigorous testing to determine their safety and efficacy in newborns and small children.

For example, an oxygen monitor (pulse oximeter) uses a sensor taped to the baby’s hand or foot to measure the oxygen level in their blood. A blood pressure machine — a smaller version of the blood pressure cuff used on older children and adults — may also help keep track of a baby’s heart rate.

Some babies too sick to eat through their mouth or nose will be fed using a nasogastric tube that passes through the throat into the stomach. These tubes are a vital piece of equipment in the NICU.