Two new-born were charred to death in the neo-natal intensive care unit (NICU) of hospitals in Delhi and Ahmedabad on Wednesday.
Two new-born were charred to death in the neo-natal intensive care unit (NICU) of hospitals in Delhi and Ahmedabad on Wednesday. The tragic incidents brought to the fore the utter need of standardisation of equipment and stricter implementation of guidelines for neo-natal care and nursing in India.
Currently, it’s go-as-you-like, with no rule or guideline to abide by, said paediatricians in the city. No wonder India has the dubious distinction of
having the world’s worst neo-natal mortality rate (NMR) and infant mortality rate (IMR).
“Pre-term (prematurely-born) babies are inherently susceptible to infections. Even the air can infect them. That is why they are kept in incubators, in which the temperature and surroundings are closely monitored,” said Dr Prasad Mahadevan, gynaecologist.
“The incubator being an electrical appliance, needs to be handled with care,” pointed out Dr Uma Venkateshwaran, paediatrician and neo-natal specialist, Swastik Hospital, Chembur. “An infant in NICU should never be left unattended.”
This is where the trouble lies. Ideally, the infant-nurse ration in an NICU, should be 1:1 for babies on ventilatory support. For only-incubator cases, there should be one nurse for a maximum of two to three infants. But in Mumbai’s overcrowded public hospitals, there is one nurse for every 15 neo-natal infants. In private hospitals, it is slightly better - 1:5.
“Such tragedies can be averted only if we standardise the equipment, formulate stricter guidelines for NICU and ensure they are implemented,” said Dr Sanjay Oak, paediatrician and dean, Nair Hospital.
Also, when it comes to electrical equipment, like incubators, doctors and nurses need to be more cautious. “These days, we have servo-controlled incubators, with automatic and manual temperature settings. When set on automatic, the incubator monitors the baby’s body temperature with the help of skin sensors and adjusts its temperature accordingly,” explained Venkateshwaran. “But even then it is essential that a nurse monitors the baby every hour.”
Most standard incubators have an in-built alarm system. “It is triggered off whenever the temperature in the incubator is one degree above or below the baby’s temperature,” she added.
The photo treatment machine that short-circuited and led to the tragedy in Ahmedabad was manufactured by Malad-based Meditrin.
“There is also an urgent need to train nurses in neo-natal care. In India, there is no such specialised course. The nurses are given on-the-job training by senior nurses and doctors,” said Dr Fazal Nabi, paediatrician, Jaslok Hospital.
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