Giraffe Shuttle – Transport of the neonate
ROYAL HOSPITAL FOR WOMEN - PROCEDURE GUIDELINE
DATE EFFECTIVE DATE FOR REVIEW RISK RATING
26/09/2014
26/09/2019
Low
REVISED BY - NIL
DATE DEVELOPED
13/09/2014
DATE REVISED
Newborn Care Centre Staff – Nursing & Medical
APPLICABLE TO
To be included in induction training of all new staff.
IMPLICATIONS
APPROVED BY
Newborn Care Centre Quality Committee October 2014
COPYRIGHT NOTICE AND DISCLAIMER
WRITTEN BY
T.George
This LOP is developed to guide safe clinical practice in Newborn Care Centre (NCC) at The Royal Hospital for Women. Individual patient circumstances may
mean that practice diverges from this Local Operations Procedure (LOP).
Using this document outside the Royal Hospital for Women or its reproduction in whole or part, is subject to acknowledgement that it is the property of NCC
and is valid and applicable for use at the time of publication. NCC is not responsible for consequences that may develop from the use of this document
outside NCC.
ABBREVIATIONS & DEFINITIONS OF TERMS
1 NICU
Neonatal Intensive Care Unit
2 MRI
Magnetic Resonance Imaging
INTRODUCTION
The Giraffe Shuttle is a transportable power source that is an accessory to the Giraffe Omni bed, Incubator and
Warmer. The Shuttle connects to the bed and provides electrical power to the bed and other auxiliary equipment,
as well as provisions for medical gas management, required for patient care during transport. The Giraffe Shuttle
facilitates the mobility of these beds within the hospital building- from birthing unit to NICU and from NICU to
other care areas like radiology and surgery.
PURPOSE
-
To provide a guideline for safe set-up and use of the Giraffe Shuttle (Loersch, et al., 2011: 203-214)
To reduce/ prevent multiple bed transfers (Altimier, et al., 1999: 37).
To minimise disruption to the infant microenvironment and preventing hypothermia (Kim, et al., 2010: e138).
To reduce the chances of physiological, cerebral and haemodynamic instability in vulnerable infants by
minimizing handling/ negative touch (Limeropolous, et al., 2009: e 1007) and (Vieira,et al., 2010: 1-7).
AIM
Effective use of Giraffe Shuttle for transport of babies in Giraffe Omni bed by Newborn Care Centre staff
- To and from NICU for surgery to operation theatres
- To and from NICU for procedures in radiology Department like MRI.
Transport an Infant in Giraffe Omnibed using a Giraffe Shuttle
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EQUIPMENT
Giraffe Omni bed Size C
Drager Babylog 8000 ventilator tubing
Flow sensor
Flow sensor housing
Expiratory Block
Test lung
500 mls water for irrigation-1
Oxygen cylinder with pressure gauge- 1
Size C Air cylinder with pressure gauge- 1
Suction tubing
Suction catheter 8Fr – 4
Suction catheter 10Fr -4
Stethoscope
Bag and mask
PROCEDURE
1.
Wash hands (R1).
2.
Collect equipment
3.
Attach the ventilator tubing and calibrate using Drager Baby Log 8000 ventilator, see relevant protocol
(R2).
4.
Check oxygen and air cylinders are full. Attach new cylinders if required (R3).
5.
Attach suction tubing to the suction chamber and check the suction pressure is 100mm Hg
6.
Check the battery life of the Giraffe shuttle (R4).
Battery Instructions (GE Health care, 2009:1-16):
Connect power cord to electrical wall outlet
Leave power switched on at all times
5 LED’s denote battery runtime available for using the shuttle (Picture 1)
Each LED has 9 minute runtime
Bottom LED flashes yellow or green when charging
When charging:
All LED’s green - battery fully charged
Bottom LED yellow or flashing – battery empty/ no runtime available
Top LED yellow, all other LED’s green – battery charged/ charging
During use:
Bottom LED, yellow – low battery, double beep every 20 seconds.
Action required – recharge battery
Bottom LED, flashing red – critically low battery, continuous tone alarm
Action required – recharge battery, do not transport patient
Bottom LED, continuous red – no battery power, continuous tone alarm
Action required - recharge battery
All LED’s flashing red: shuttle overload, beeping alarm
Action required – unplug unnecessary devices, turn shuttle off, then on.
Battery health (GE Health care, 2009:1-16) :
Single LED next to battery life LED’s
Green – healthy battery
Yellow – schedule battery replacement, 3 beep auditory alarm
Flashing red – critical, do not use shuttle, 3 beep auditory alarm
NOTE: Shuttle must be connected to wall electrical outlet and switched on at all times, when not in use. Transport
in closed bed mode when possible (GE Health care, 2009:7).
Transport an Infant in Giraffe Omnibed using a Giraffe Shuttle
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Picture 1:
Picture 2
7. Unplug the shuttle from wall outlet and secure power cord in wrap bracket (R6).
8.
Press down on unlock pedal (Picture 2) (R7).
9. Position shuttle at the bottom end of Giraffe Omni bed (Picture 3) R8).
Picture 3:
10. Check that the Giraffe Omni bed wheels are locked (R9).
11. Push the Giraffe Shuttle in, straight between the legs or wheels of Giraffe Omni bed (Picture 3) (R10).
12. Check the indicator light. When the red light next to STOP Illuminates, the shuttle is ready to be locked.
(Picture 2) (R11).
NOTE:
DO NOT attempt to transport when STOP is illuminated. The shuttle is not properly connected to the
bed (GE Healthcare, 2009:13)
13. Press down on the lock pedal (Picture 4) (R12).
Transport an Infant in Giraffe Omnibed using a Giraffe Shuttle
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Picture 4:
14. When properly locked the green light next to GO is illuminated (Picture 4).
15. Plug shuttle into electrical power source and attach ventilator tubing to wall gas outlet (R13).
16. Set ventilator parameters according to infants need (R14).
17. Disconnect power cords of Giraffe Omni bed and accessories (E.g.: IV pumps) and attach to power outlets on
both sides of the shuttle (Picture 5) (R15).
Picture 5:
18. Remove the infant’s cardiopulmonary monitoring module and insert it into the shuttle cardiopulmonary
monitor (R16).
19. Stop Omni bed humidification before transport. Empty the humidifier reservoir (R17).
20. Transport in closed bed mode when possible
21. Select manual or baby mode of temperature control in the Omni bed depending on other thermal control aids
to used: hats, clothing, thermal mares, polyurethane bags or blankets (R18)
22. Check that the thermal skin probe is attached to the infant’s skin (R19, 20).
23. Check vital signs (R21)
24. Ensure that all tubing, attachments and lines have sufficient slack (R22).
25. Ensure that sufficient slack of the Silo support, if infant has Silo bag (R23).
26. Open the gas cylinders and disconnect gas tubing from wall. Evaluate ventilation settings with new gas source
and infant’s saturation (R24).
Transport an Infant in Giraffe Omnibed using a Giraffe Shuttle
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27. Disconnect Shuttle power cord from the from wall outlet after checking the infant and when ready to move.
(R25)
28. During transport (R26):
-
Minimum of 2 personnel needed for transport
3 people may be needed for ramp or incline
Observe infant during transport. Stop if there is an alarm condition
Monitor infants’ temperature and oxygen levels during transport
NOTE:
Shuttle can be disconnected from the Omni bed if space is limited. The bed and shuttle can then be plugged into
wall power separately.
29. On arrival:
Ensure that shuttle is plugged into power source (R27).
Connect ventilator to the wall supply and turn the gas cylinders off
Check whether there is sufficient gas in the cylinders prior to leaving for the return trip
30. After transport:
Set bed and shuttle wheel locks
Disconnect all power cords and gas lines from shuttle and reconnect to wall outlets
Press down on the unlock pedal to disconnect from bed. The red light next to stop will illuminate
Move the shuttle away from the bed. The STOP light will turn off.
Discard all the used disposable accessories
Terminally clean the shuttle
Plug back into designated power point (R28).
RATIONALES
R1
To adhere to 5 moments of hand hygiene
R2
To ensure ventilator is functional and ready for use
R3
To ensure adequate gas supply for transportation
R4
To ensure suction apparatus is functional in case of need for suctioning
R5
To ensure there is adequate battery power to operate Shuttle during transportation
R6
To prevent tripping over the electrical cords (GE Health care, 2009: 6)
R7
To activate the unlocking mechanism
R8
To attach Shuttle to the Giraffe Omni bed
R9
R10
To prevent accidental dislodgement / movement of Giraffe Omni bed
To connect Shuttle to the Giraffe Omni bed
R11
To prevent accidents from improper connection/attachment of equipment
R12
To activate the locking mechanism
R13
To reserve battery and gas of shuttle for transport
R14
To provide adequate ventilator settings during transport
R 15
To provide uninterrupted battery supply for the accessory equipment like IV pumps
R16
To transfer continuous cardiopulmonary monitoring to the shuttle
R17
R18
R19
To prevent water spill from humidifier reservoir with movement and minimise the risk of accidental burns (GE Health care,
2009:7)
To maintain optimal thermoregulation
For maintaining thermal neutrality (Altimier, et al., 1999: 36)
R20
To monitor infant temperature during transport
Transport an Infant in Giraffe Omnibed using a Giraffe Shuttle
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R21
R22
R23
R24
R25
R26
R27
R28
To have a baseline observation to reference any deviation
To minimise the line tension and to prevent accidental dislodgement (Loersch, et al., 2011: 210)
To prevent tension to abdominal wall (GE Health care, 2009:15)
To ensure ventilator is operational and ventilation parameters are remaining same as set
To ensure shuttle is ready to move
To ensure safe transport of the infant (GE Health care, 2009: 15)
To recharge battery for further use, to reserve gas for return transport and to ensure adequate gas supply for transportation
To prevent cross infection according to the waste disposal guidelines and to recharge battery for further transport
References
Altimier, L., Warner, B., Amlung, S. and Kenner, C. 1999 Neonatal thermoregulation: Bed surface transfers. Neonatal network 18, 9, 35-38.
GE Healthcare 2009 Giraffe Shuttle: Instruction manual. GE Company, Laurel, U.S.A.
GE Healthcare 2007 Physiological and behavioural responses of preterm newborns to various types of procedural touch. GE Company,
Laurel, U.S.A.
Kim, S. M., Lee, E, Y., Chen, J. and Ringer, S. A. 2010 Improved care and growth outcomes by using hybrid humidified incubators in very
preterm infants. Paediatrics 125, 1, e137-45.
Limeropolous, C., Gauvreau, K, K., O’Leary, Moore, M, Bassan, H., Eichenwald, E, C., Soul, J, S, Ringer, S, A., Di Salvo. And Plessis, A, J. 2009
Cerebral hemodynamic changes during intensive care of preterm infants. American Academy of Paediatrics 122, e1006-e1013.
Loersch, F., Schindler, M., Starr, K., Moore, J. and Bayne, L.L. 2011 Risk factors for intra hospital transport of newborn patients: A new
solution to an old problem. Journal of Neonatal Nursing 17, 203-214.
Vieira, A. L. P., Santos, M. N., Okuvama, M. K., Mivoshi, M. H., Almeida, M. F. B. and Guinsburg. 2010 Factors associated with clinical
complications during intra hospital transports in a neonatal unit in Brazil. Journal of tropical paediatrics, Dec, 1-7.
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