Initiating Infant Flow SIPAP - Southern Health and Social Care Trust

SOUTHERN HEALTH & SOCIAL CARE TRUST
Children & Young People’s Directorate
Procedure/Guidelines/Protocol Checklist & Version Control Sheet
1 Name of Procedure/Guidelines/
Protocol:
2 Purpose of Procedure/
Guidelines/ Protocol:
PROCEDURE FOR INITIATING INFANT
FLOW SIPAP IN A NEONATE
To ensure correct initiation of flow SIPAP
in a neonate
3 Replaces: New
4 Applicable to which staff: Neonatal and SCBU nursing staff
5 Name & title of author: Una Toland Lead Nurse Neonatal
Services and ANNP team SH&SCT
6 Equality Screened by:
N/A
Note any issues:
7 Proposals for dissemination: Una Toland via team managers to
nursing staff
8 Proposals for implementation: With immediate effect
9 Training Implications: To be included in induction training of all
new nursing staff
10 Date Procedure/Guideline/ 31:03:13
Protocol submitted to
Procedures Committee:
11 Outcome: Approved Comment:
Approved/Minor
amendments
Not approved
Deferred
12 Date of CYP SMT approval
Comments:
13 Date of approval by Trust SMT
(if required):
14 Date approved by HSCB (Social
Work only):
15 Date for further review (3 year
default):
16 Date added to repository:
17 Date added to Intranet:
State where to be placed on
Intranet:

SOUTHERN HEALTH & SOCIAL CARE TRUST
PROCEDURE FOR INITIATING INFANT FLOW SIPAP IN A
NEONATE
Statement: To provide a non-invasive form of continuous positive airway
pressure to babies with respiratory difficulties.
Equipment: Infant flow SIPAP, MR290 humidification chamber
Circuits
Nasal prong / mask (size appropriate)
SIPAP hat (size appropriate)
Hat measuring tape
1 litre bag of sterile Water and extension set
ACTION
Where possible parents should be
informed of planned procedure
Decontaminate hands as per local policy
adhering to 7 step technique and 5
moments of hand hygiene.
Ensure infant flow SIPAP has been
decontaminated and functionally checked.
RATIONALE
To gain consent and cooperation
To reduce risk of cross contamination
To prevent the risk of cross infection.
Plug into mains and connect air and
oxygen connections to supply.
Carry out two point oxygen calibration as
per manual.
Carry out low and high airway pressure
alarm as per manual and set pressures as
prescribed.
Adjust % oxygen control as prescribed.
To provide electric supply and gases to
equipment.
To ensure correct oxygen concentration is
delivered to the baby.
To ensure correct pressure is delivered to
baby. Also to ensure correct oxygen and
carbon dioxide exchange.
To ensure correct oxygen concentrations.

SOUTHERN HEALTH & SOCIAL CARE TRUST
Use disposable self-filling humidifier tubing
with 1 litre of sterile water and attach to
MR290 humidifier. Temperature of
humidifier must be set between 36oc and
never higher than 37 o c.
Measure for prong / mask size using the
measurement guide provided.
Measure for bonnet size using the
measuring colour coded tape provided.
Measure from middle of the forehead to
the nape of the neck and then back to the
middle of the forehead.
Loosely weave generator straps through
the bonnet holes.
Place bonnet onto baby’s head checking
that the ears are in a normal position. Pull
down well over ears and down to the nape
of the neck.
Lift the generator from the top of the
bonnet and bring towards the nose. Gently
insert the nasal prongs / mask into the
nasal airways.
Secure the straps horizontally across the
cheeks and do not tighten.
Secure all three tubes from generator with
the central Velcro strap. Split the
inspiratory and pressure lines and secure
with secondary Velcro straps. Tie the
open end of the bonnet if desired. Ensure
nose is in neutral position, eyes visible and
ears not folded.
Ensure tubing with humidification
temperature probe is situated at grommet
of the incubator door.
Loosen the generator straps and release
the tubes from the central Velcro strap
every 3-4 hours and clean the nasal area
with sterile water.
To ensure adequate humidity to prevent
drying of secretions and to ensure patency
of nasal airway.
To ensure correct positioning of nasal
prong / or mask. To prevent nasal
irritation, septal distortion, skin irritation
and pressure necrosis.
To provide correct pressures and oxygen.
To prevent nasal irritation, septal distortion,
skin irritation and pressure necrosis.
To ensure bonnet is situated securely and
comfortably.
To prevent nasal irritation, septal
distension, skin irritation and pressure
necrosis.
To prevent septal distension.
To ensure adequate delivery of oxygen
and pressures. To prevent pressure
necrosis.
To prevent the accumulation of water that
causes condensation in tubing.
To ensure patency of nasal airways, to
prevent build-up of mucous.

SOUTHERN HEALTH & SOCIAL CARE TRUST
Record hourly oxygen concentration levels
CPAP pressures delivered and
humidification temperature.
Monitor blood gases as directed by
attending Consultant/ANNP
If infant is nursed on continuous SIPAP.
The circuit should be changed every seven
days. Change the nasal prong insert every
day.
After use ensure equipment is
decontaminated as per manufacturer’s
instructions.
To ensure correct oxygen, pressures and
humidification temperature is delivered to
baby.
To ensure adequate oxygen and carbon
dioxide gas exchange and to facilitate
weaning.
To minimise the risk of cross infection.
Some bacteria which colonise the nasal
passages produce large amounts of
mucous. Changing of nasal prongs daily
reduces build-up of bacterial colonisation
of nasal passages.
To ensure the prevention of cross
infection.
March 2013
References :
Newborn services clinical guidelines (2010)
www.adhb.govt.nz/newborn/guidelines/respiratory/CPAP/CPAPSetup.htm