Some babies are born premature (before 37 weeks of pregnancy), or having low birth weight, or a medical condition such as heart problems, infections, or birth defects that require an immediate intensive medical care in the NICU (Neonatal Intensive Care Unit). Millions of babies are born preterm worldwide, and many of these babies also have low birth weights, or medical condition that requires special care.
This could be particularly overwhelming for the new parents who are eagerly waiting to bring their baby home, just to learn that their baby has to be admitted to the neonatal intensive care unit instead.
Treating babies in intensive care is also stressful for NICU staff, particularly for junior doctors and nurses, especially when they're required to make immediate, often life-affecting decisions. Having the on-the-spot expert support would be more than helpful in situations like these.
Once 'a junior neonatal doctor' himself, Dr Christopher Kelly, a researcher from King's College London and a doctor at St Thomas' Hospital, designed a free smartphone app NeoMate - an expert decision support and advice for junior doctors working in the NICU, as well as neonatal nurses preparing the baby for transfer to a tertiary neonatal unit.
The app that has been also awarded the NHS Innovation Acorn Challenge Prize, is made with the goal to improve outcomes for newborn babies who require intensive care following birth, especially the babies born in local smaller hospitals without a tertiary neonatal intensive care service.
The NeoMate app is based upon established guidelines by the London Neonatal Transfer Service (NTS), providing a drug, infusion and fluid calculations, concise checklists for common clinical problems, as well as quick reference information to guide acute neonatal intensive care.
As it has been said, this app is designed for neonatal doctors and nurses, who are often under stress during neonatal emergencies, which makes them prone to errors. For example, sick babies often need intravenous drugs that require dilution before being given as an infusion. Calculations to prepare these infusions are complex, so having a mobile app with concise guidelines is more than helpful.
The app opens to the main screen that features NICU calculators, including drugs calculators (cardiac, sedative, emergency) and IV fluid calculators, intubation guidance, cooling criteria, oxygenation index, drugs required when admitting baby to the Unit, and other calculators.
In order to use these calculators, you first have to enter baby's weight in grams, either known or estimated with the help of table containing birth weights by gestation period. Basically, baby's weight is the only data you'll need, which makes the calculators straightforward and very easy to use.
Next tab leads you to the simple and concise checklists aimed to support decision making process. These checklists cover many difficult situations and conditions in NICU, from neonatal transport, extreme preterm delivery, term babies with serious conditions, such as respiratory distress, encephalopathy, necrotizing enterocolitis, etc.
It should be noted that these checklists are not intended to replace local guidelines. Also, none of these checklists is a step by step guide. Instead, they provide a series of prompts for staff, making sure that nothing is forgotten or missed.
Also, members of NICU staff are advised to read principles of Crisis Resource Management (CRM), developed in the 1970s by aviation industry, after learning that 85% of aircraft crashes are caused by human error, which could also be useful to anyone working in NICU. CRM includes 15 key points shown in a form of colorful graph and explained in concise manner.
Reference is the next tab, containing reference information for neonatal staff, including more detailed BAPM Guidelines for Extreme Prematurity that provides exhaustive information on management of babies born at less than 26 weeks of gestation, or guide on how to interpret early CFM (Cerebral Function Monitoring) results with image samples, to more concise information given in table with endotracheal tube lengths, Sarnat staging, and cooling criteria.
The last tab contains 'About' page that tells more about the NeoMate app and its creators, also containing links to the sources used for the information provided in this app.
This isn't the only part of this app that contains the useful links. The NeoMate is well-referenced throughout, which is a great plus for the app aiming to be the expert decision support to all junior doctors and nurses working in stressful environments of neonatal intensive care units.
NeoMate app is exactly that – the on-the-spot expert support, not intended to replace local guidelines, but rather to be used along with them in dealing with complex neonatal intensive care.
Benefit: Doctors, junior doctor and nurses working in neonatal intensive care unit (NICU)