1. Supportive Care

► Ongoing assessment
      ♦ Infant, interface, CPAP machine

► Feeding considerations

2. Ongoing assessment

Complete assessment: 4-6 hour
Vital signs: 2-3 hour

3. a. Infant monitoring

► Appearance: Comfort, color, posture

► Vitals: Temperature, HR, RR, SpO₂, BP

► CVS: Pulse volume, CRT, urine output, BP

► CNS: Activity, tone, responsiveness

► GIT: OGT, abdominal distension

► Settings: FiO₂, CPAP and flow

4. Respiratory monitoring

SILVERMAN SCORE

5. Optimal positioning

► Reposition every 3 to 6 hours

► Nesting
      ♦ Promote flexion, containment and comfort

6. Airway monitoring

► Note the color, consistency, & quantity of nasal secretions

► Suction the mouth, nose and pharynx

► Moisten the nares with normal saline or sterile water

7. b. Interface

► Prongs fitting snuggly?

► Symmetry of nares?

► Blanching of skin at nares?

► Skin breakdown?

► Gap between columella and prongs?

8. Assessing the nasal interface

► Is the cap appropriately placed?

► Is the nasal interface componenttwisted?

► Compress the tip of the nose

9. Assessing skin integrity

► Color

► Quality of perfusion

► Possible areas of pressure or excoriation

10. c. Monitoring CPAP system

11. Humidification

♦ Set the humidifier in invasive mode
♦ Water level correct
♦ No condensation in inspiratory limb
♦ Condensation in expiratory limb

12. Radiologic monitoring

13. Feeding considerations

14. Summary

► Monitoring of
      ♦ Infant, interface and CPAP system

► Respiratory monitoring

► Feeding consideration