It was recently brought to my attention that Sonicu might play a vital role in improving the health of patients in Intensive Care Unit (ICU's) as well as NICU's.  Specifically, some believe Sonicu can greatly benefit those susceptible to ICU Psychosis or Delirium.  Normally, when people are seeking out Sonicu as a Baby monitoring system or Neonatal monitor, they find us on the web and give us a call.  It is normally during a baby's Neonatal Period that our product receives the most attention.  With the advent of new research, Sonicu could be the Audio Monitor of choice for ICU's to control the loud noises in their ICU's and common areas as well. 
A recent article at http://www.medicinenet.com/icu_psychosis/article.htm explains

Environmental Causes (Snipet of Article)

  • Sensory deprivation: A patient being put in a room that often has no windows, and is away from family, friends, and all that is familiar and comforting.
  • Sleep disturbance and deprivation: The constant disturbance and noise with the hospital staff coming at all hours to check vital signs, give medications, etc.
  • Continuous light levels: Continuous disruption of the normal biorhythms with lights on continually (no reference to day or  night).
  • Stress: Patients in an ICU frequently feel the almost total loss of control over their life.
  • Lack of orientation: A patient's loss of time and date.
  • Medical monitoring: The continuous monitoring of the patient's vital signs, and the noise generated by monitoring devices can be disturbing and create sensory overload.

Let's hope some forward thinking and proactive hospitals will look to Sonicu to help in this regard.  Sonicu can even aide with the lighting by controlling the day cycle of overhead lighting.  It's built under the hood of every Sonicu controller. (requires ballast change out)


Although St. Luke's has yet to implement the Sonicu Solution, they are actively promoting their sound and lighting controlled NICU.  I've not spoken with them yet but plan to do so shortly.  Here is some text from their's website discussing their Baby Monitoring Device for infants staying in the NICU during their Neontal period.  Clearly, they believe sound monitoring and lighting control are important to the health of the smallest amound us.

...."After decreasing noise and reducing inappropriate light, babies spend less time on intravenous nutrition. Babies not only grow faster, but their compromised immune systems are less susceptible to infections. "

Here's a study published in December of 2007 and was undertaken in Brazil.  The findings suggest periodic monitoring of environments be established to accurately determine levels and implement a control strategy.  I suggest "Real Time monitoring 24 hrs a day, 7 days a week, 365 days a year via "SONICU" is optimal.  Here's the concluding paragraph from the study.

....Considering the sound pressure high levels found in the study and their deleterious effects on newborns and the health team, the results point out the need to include interventions targeting the routine of equipment maintenance and the attitude of relatives and professionals through continuing educational programs. Monitoring of sound pressure levels should be done periodically, in the morning, in the afternoon and at night and on different days of the week.

>>> LINK <<<

 

Public Hospitals Redesign Neonatal Intensive Care Units
to Mimic Benefits of Mother’s Womb

New Equipment, Environmental Changes Improve Health
for Premature Babies


The New York City Health and Hospitals Corporation (HHC) today unveiled the first of 11 neonatal intensive care units (NICU) that will be specially designed to mimic the nurturing environment of the mother’s womb, reduce the stress of the NICU experience and help the immediate and long term health of premature babies.

"We want to improve the quality of care and health outcomes of the littlest New Yorkers by dramatically reducing stressful external stimulation and nurturing them as if they never left their mother’s womb prematurely," said HHC President Alan D. Aviles. "Loud noises and bright lights interrupt babies' sleep patterns and interfere with the healing and developmental process that occurs during their sleep. We know that premature babies who receive developmental care which eliminates external stimuli can feed on their own quicker, go home sooner and ultimately have better short and long-term outcomes than babies who don't."

HHC’s Queens Hospital Center NICU has been retrofitted with high tech incubators and monitoring devices to control excessive light, noise and room temperatures, which have been proven to impact a preemie’s ability to wean from oxygen support, reach desirable weight and be discharged from the hospital sooner. In addition to eliminating harmful external stimuli in the NICU’s, HHC’s new $3 million Developmental Care Initiative also:

  • adopts the consistent use of swaddling the babies in a womb position;
  • uses modern multi-function beds that convert from radiant warmers to incubators with the touch of a button to eliminate the stress of moving fragile preemies;
  • encourages breastfeeding and skin–to–skin bonding between the baby and their parent known as kangaroo care;
  • clusters all the clinical care activities around the baby;
  • develops care and intervention plans tailored to each baby;
  • offers training and education to new parents.

"The number of at-risk pregnancies continues to climb, especially pregnancies affected by obesity, diabetes and high blood pressure. All of these factors increase the risk of preterm birth. The NICU redesign ensures that Queens Hospital and HHC’s other neonatal intensive care units are the best facilities for at-risk mothers-to-be and their infants in New York City," said Dr. Ivan Hand, Director of Neonatology, Queens Hospital Center.

HHC’s 11 hospitals treat a disproportionate number of the City’s high-risk pregnancies and delivered more than 23,000 babies in 2007. Last year nearly 24% or 5523 babies were born prematurely or critically ill, and required treatment in the NICU’s. According to the March of Dimes, prematurity and low birth weight is the leading cause of neonatal death within the first month of life among babies born in the United States.

"Implementing developmental and family-centered care as a best practice in the public hospitals will have enormous measurable impact in the areas of public health and maternal child healthcare including long and short term outcomes, length of stay, parental bonding and coping, staff satisfaction and hospital costs," said Dr. Randi Wasserman, Developmental Care Initiative Principal Investigator/Co-director, Bellevue Hospital Center Regional Perinatal Center. "Our program is unique and innovative and will serve as a model for other NICU’s across the city, state and country."

Studies published in the Journal of the American Medical Association, attribute unnecessary external stimuli with poor health outcomes in premature infants. Once fully implemented system-wide in 2009, every HHC NICU will be equipped with state-of-the-art clinical monitoring equipment, bedside computers and sound monitors that flash warnings to staff when the noise level exceeds the established limit of 45 decibels – ensuring the preemies are able to get the quiet rest they need.

"The Developmental Care training provided by the nursing staff allows new parents and caregivers to quickly become comfortable and confident in handling the baby. Since the babies’ hospital stays are shorter, developmental care unites families faster and is cost-effective," said Leah Smith, RN, AED, Women’s Health Services.

All HHC hospitals are designated by the State Department of Health as Perinatal Centers, with two - Jacobi Medical Center and Bellevue Hospital Center - designated as Regional Perinatal Centers that treat the most critically ill babies. The babies are cared for by highly qualified NICU nurses, board certified neonatologists and certified neonatal nurse practitioners. Additional team members include developmental specialists, lactation consultants, registered dieticians, occupational/physical therapists and social workers who create a nurturing environment for premature babies and their families.

"Childbirth should be one of life’s most joyful moments but for many mothers who deliver preterm it’s a time of worry and sorrow," said Antonio D. Martin, Executive Director, Queens Hospital Center. "Our effort to reduce premature birth starts at the first prenatal visit. Mothers with high-risk pregnancies or those with preemies can rest assured that their infants are cared for in new modern settings, by staff trained in medicine’s best practices - ultimately ensuring a better health outcome for their child."

HHC's Developmental Care Initiative has also been funded by the New York State Health Department, and the Ambrose Monell Foundation through the HHC Foundation. The Developmental Care NICU upgrades are scheduled to be completed by the end of 2009.

The New York City Health and Hospitals Corporation (HHC), the largest municipal hospital and health care system in the country, is a $5.4 billion public benefit corporation that serves 1.3 million New Yorkers and nearly 400,000 who are uninsured. HHC provides medical, mental health and substance abuse services through its 11 acute care hospitals, four skilled nursing facilities, six large diagnostic and treatment centers and more than 80 community based clinics.


Here is an interesting article that shows the requirements of the Neonatal Intensive Care Units and what the hospital staff must do to maintain those requirements.  It also has some interesting statistics regarding Neonatal Instruments and Neonatal equipment, so check it out here.

Here is another study, this time conducted by the American Academy of Pediactrics.  It is titled "Noise: A Hazard for the Fetus and Newborn."

..... "Many studies have documented hearing loss in children cared for in the NICU (NICU graduates)." .....

A recent survey sponsored by MedImmune, the makers of Synagis, shows worrisome gaps in health care provided to preemies. MedImmune surveyed 202 neonatologists and pediatricians about current attitudes and practices when caring for the specialized health needs of preterm infants. Sadly, 70% of respondents felt that the health care system in the US failed place enough emphasis on or dedicate enough resources to preventive health care for preemies.

Luckily, Sonicu monitoring equipment has the potential to help the U.S. obtain a better reputation of health care for preemies.

An independent study conducted by the American Institute of Physics tried to find out whether differences in sound levels occurred near babies who are more/less premature.  Here is the research abstract:

We conducted sound surveys in a large state of the art NICU with six separate rooms devoted to the sickest babies requiring the most intensive care (Level III) and six rooms devoted to babies requiring special but less intensive care (Level II). Each room was capable of caring for up to 8 babies. Additionally, there were 8 individual Isolation rooms. We used Larson Davis Spark squflg 703+ dosimeters to record 21 week long sound surveys, seven in each type of room. The American Academy of Pediatrics (1997) has recommended that sound levels in NICUs should never exceed 45 dB(A). That recommendation was exceeded 73.6% of the time in Level II, 92.1% of the time in Isolation, and 96.6% of the time in Level III. Sound levels were lowest in the Level II rooms especially for the softest sounds recorded (L90 and L70). Level III rooms were noisiest except for the noisiest decile of sound (L10). Isolation rooms were noisiest at the highest sound levels (probably because of their reverberant construction materials and enclosed space). Autocorrelation functions were calculated identifying periodic components in all three rooms at about 12 and 24 hrs. Periodic variations were very small compared to random sound variations.

The Indianapolis Star recently ran a story on the front page of the Business section about Sonicu and my monitoring equipment.  I was excited to get the somewhat mainstream attention for Sonicu neonatal instruments.

Indy Star

Deaconness Hospital - Newburgh, IN (Division of Riley Children's Hospital in Indianapolis) seems pleased with their Sonicu system.  The following article lists some benefits the hospital has noted, including better rest for babies and stress reduction overall.  Click here for the story

There was a recent article run in neonatal Intensive Care: The Journal of Perinatology-Neonatology about Sonicu.  The article describes what my audio monitor does and called the Sonicu system the "first fully networked and integrated sound monitoring and advisory system for the NICU and other environments where excessive noise levels are a problem."

One of the latest systems we've installed was for Community Hospital North. 
They are a part of the Community Health Network

The hospital installed sound monitoring units (Sonicu System) in its neonatal units to alert staff and family members when the decibel level exceeds the threshold considered safe for developing preemies. A yellow light cautions that the sound is approaching dangerous levels and a red light calls for quiet. >> Web Article <<

They're one of many hospitals who've chosen Sonicu for their audio monitoring and control needs


While concerns regarding the effects of the neonatal intensive care unit (NICU) sound environment have primarily centered on infants, caregivers are exposed to the same auditory stimuli. In a review of the literature on adult responses to sound, behavioral and physiological responses to sound as well as influence on job performance and communication are examined. Hearing damage among caregivers is unlikely given the sound levels of the typical NICU. The effect of the NICU sound environment on caregivers has received little attention in research; however, findings from other researches of responses to sound suggest that a variety of physiological and behavioral responses may occur in response to the NICU sound environment, and that the sound intensity of the NICU may interfere with communication and job performance. Journal of Perinatology 2000; 20:S94-S99.

>> Article Link <<

Here's an interesting article about how excessive noise effects not only babies in NICUs but also those who care for them.  You might think all the baby monitoring systems and monitoring devices in a typical NICU would be all that's required to facilitate good care.  Here's proof more is needed for proper speech communication.  Did the care giver hear the right dose?

Environmental noise is a major source of stressful stimulation that can agitate and further complicate medical management of the neonate (Graven, 2000)....

During this same time, a multidisciplinary group of physicians, nurses, and researchers formed the Physical and Developmental Environment of the High-Risk Infant Center Study Group on NICU Sound to develop recommendations for practice based on sound research evidence. Specific to the NICU environment, the recommendations included the development of a program of noise control to maintain nursery sound levels at or below the recommended noise criteria and care practices to allow parent-infant interaction (Graven, 2000).

>> Story Link <<

The information in this article is a few years old but just as relative today as it was in 2001.  Clearly maintaining some type of monitoring device to assure babies are protected from excessive noise is called for.

The Neonatal Intensive Care Unit (NICU) design standards have been around for a while now.  Two of the standards I'm most concerned with are for controlling Noise and Sound.  This standard does a good job setting the limits but it's often up to the individual NICU to determine how best to comply.  In addition, design engineers need to "design in" both the acoustics & proper lighting control to assure the best results can be achieved. 

Standard 23: Acoustic Environment
Standard 14: Ambient Lighting in Infant Care Areas

Standard Link >>> Design Standards <<<

There are several products available to assist in meeting or exceeding these standards.  Sonicu ( www.sonicu.net ) is the best system on the market today to control and give feedback for compliance to both of these standards.  When monitoring your NICU, you should seriously consider Sonicu.

Chris Smith


Here's a great story recently aired on the CBS Evening News about Neonatal Intensive Care Units (NICU) and their efforts to treat pain in tiny infants.  Katie Couric leads into the story & Sanjay Gupta is reporting from the NICU.  Not only does the story touch on a subject that's near and dear to my heart (Preemies and their environment) but it also touches on some of the equipment & monitors being used to mitigate pain for these little ones. 
Having witnessed first hand the effects lighting and sound can have on babies subjected to this type of environment, it's great to see the media covering topics of this importance.  My product (Sonicu - www.sonicu.net ) was developed by me to minimize two aspects of a baby's environment while in a NICU.  Sound monitoring & lighting control are the two primary focuses of Sonicu and can be successfully controlled once implemented to rectify some of the things noted in this article. 

I was surprised to hear how premature births have increased 20% since 1990 & how that equates to an additional 500,000 births/year ending up in a NICU.  It's great to see Neonatal product and services being directed to making a difference.  Having had a child in a NICU, I can attest to the wonderful care these doctors and nurses extend to care for little babies. 

I hope to hear more about this issue in the future & am glad to see it given the attention it deserves.

Chris Smith