Neonatal Oxygen Hood
Understanding Oxygen Therapy Devices for Newborns and Infants
Introduction
A neonatal oxygen hood, also called an oxygen head box or oxy hood, is a medical device designed to deliver controlled oxygen therapy to newborns and young infants. This transparent plastic hood fits over the baby's head and upper body, creating an oxygen-enriched environment that helps babies with breathing difficulties receive the oxygen they need.
The oxygen hood is widely used in neonatal intensive care units (NICUs), pediatric wards, and delivery rooms worldwide. It provides a non-invasive method of oxygen delivery that allows healthcare providers and parents to observe the baby while ensuring effective respiratory support.
Purpose and Medical Uses
Common Medical Conditions
Oxygen hoods are used for babies with:
- Respiratory distress syndrome (RDS)
- Transient tachypnea of the newborn (TTN)
- Mild to moderate hypoxemia (low blood oxygen)
- Pneumonia or lung infections
- Meconium aspiration syndrome
- Prematurity with breathing difficulties
- Post-surgical recovery requiring oxygen support
- Apnea of prematurity (in some cases)
Where They Are Used
- Neonatal Intensive Care Units (NICUs)
- Special Care Nurseries
- Pediatric Emergency Departments
- Delivery rooms for immediate newborn stabilization
- Pediatric wards
- Transport incubators
Types of Oxygen Hoods
| Type | Description | Best For |
|---|---|---|
| Standard Oxygen Hood | Clear plastic hood with open bottom, single oxygen inlet port | Most newborns and infants up to 5-6 kg |
| Large Oxygen Hood | Bigger size for larger infants, same design principle | Infants 5-10 kg or older babies |
| Servo-Controlled Hood | Includes temperature monitoring and oxygen blending systems | Critical care settings requiring precise control |
| Disposable Hood | Single-use plastic hood | Infection control situations, transport |
| Reusable Hood | Durable plastic, can be sterilized and reused | Hospital settings with proper sterilization facilities |
Key Components
- Transparent plastic dome or box
- Oxygen inlet port with tubing connection
- Outlet port for gas exhaust
- Access ports for monitoring equipment
- Neck seal or cushion (in some models)
How to Use: Step-by-Step Guide
Setup Procedure
Ongoing Monitoring
- Check oxygen concentration every 1-2 hours
- Monitor baby's respiratory rate, color, and work of breathing
- Record oxygen saturation (SpO2) continuously
- Assess temperature inside hood regularly
- Check for condensation and empty water traps
- Document all settings and observations
Flow Rate Guidelines
| Hood Size | Minimum Flow Rate | Typical Range |
|---|---|---|
| Small (newborn) | 7 L/min | 7-10 L/min |
| Large (infant) | 10 L/min | 10-15 L/min |
Precautions and Safety Measures
- Never use oxygen near open flames or smoking areas
- Never completely seal the hood - CO2 must escape
- Never leave baby unattended while on oxygen therapy
- Never adjust oxygen concentration without medical orders
General Precautions
- Always use humidified oxygen to prevent drying of airways
- Keep oxygen analyzer calibrated and functioning
- Maintain minimum flow rates to prevent CO2 retention
- Avoid sudden changes in oxygen concentration
- Keep hood clean and free from condensation
- Ensure adequate space around baby's neck
- Position hood to allow easy observation
- Keep emergency equipment nearby
- Follow infection control protocols
- Document all interventions and baby's response
Potential Complications
- Oxygen toxicity: From excessive oxygen concentration or prolonged use
- Retinopathy of prematurity: Eye damage in premature infants from high oxygen
- CO2 retention: From inadequate flow rates
- Hypothermia or hyperthermia: From poor temperature control
- Skin breakdown: From pressure or moisture
- Noise stress: From high gas flows
When to Seek Immediate Help
- Baby becomes blue or gray in color
- Breathing becomes very fast or stops
- Baby becomes unresponsive or lethargic
- Oxygen saturation drops below prescribed levels
- Equipment malfunctions or alarms sound
- Baby appears distressed or agitated
Maintenance and Care
Daily Cleaning (During Use)
- Wipe exterior with damp cloth every shift
- Empty water condensation from tubing regularly
- Check and clean oxygen analyzer sensor
- Inspect all connections for leaks
- Replace humidifier water as per protocol
Between Patients (Reusable Hoods)
- Disassemble all removable parts
- Wash with warm soapy water or enzymatic cleaner
- Rinse thoroughly with clean water
- Sterilize according to manufacturer instructions (autoclave, chemical disinfection, or gas sterilization)
- Allow to dry completely before storage
- Inspect for cracks, cloudiness, or damage
- Replace if damaged or unclear
Storage Guidelines
- Store in clean, dry area away from direct sunlight
- Keep in protective covering or designated storage area
- Avoid stacking heavy items on hoods
- Keep away from heat sources
- Store tubing separately to prevent kinking
- Maintain inventory of different sizes
Equipment Checks
- Calibrate oxygen analyzer daily or per manufacturer guidelines
- Test oxygen source and flowmeter function
- Check humidifier water level and function
- Inspect tubing for cracks or leaks
- Verify all connections are secure
- Test alarm systems if present
Advantages and Limitations
Advantages
- Non-invasive oxygen delivery method
- Allows direct observation of baby's face and chest
- Provides stable oxygen concentration
- Comfortable for baby - no face mask or nasal prongs
- Easy access for feeding and care
- Can deliver precise FiO2 levels (up to 80-90%)
- Reduces risk of nasal trauma
- Quiet operation compared to some devices
Limitations
- Requires adequate flow rates to be effective
- Limited to babies who can breathe spontaneously
- Cannot provide positive pressure support
- FiO2 varies if hood is frequently opened
- Temperature control can be challenging
- Not suitable for active or older infants who move frequently
- Takes up space in incubator or warmer
- Noise from gas flow can be stressful
Frequently Asked Questions
How long can a baby stay on an oxygen hood?
Duration varies based on the medical condition. Some babies need oxygen for hours, others for days or weeks. The healthcare team gradually reduces oxygen as the baby improves.
Can I touch or hold my baby while using an oxygen hood?
Yes, but with precautions. The hood can be briefly lifted for essential care, feeding, or bonding. Always coordinate with nursing staff and minimize the time hood is removed.
What oxygen concentration is typically used?
This varies by medical need. Concentrations typically range from 30% to 80%. The goal is to use the lowest effective concentration to maintain normal oxygen saturation.
Is oxygen hood better than nasal cannula?
Each has advantages. Oxygen hoods provide more stable FiO2 and avoid nasal trauma, making them better for acute situations. Nasal cannulas allow more mobility and are preferred for long-term therapy.
Why must the oxygen be humidified?
Humidification prevents drying and damage to the baby's delicate airways and mucous membranes. Dry oxygen can cause irritation and thicken secretions.
Can babies feed while on oxygen hood?
Yes. Babies can be fed by bottle, breast, or tube feeding. The hood may be briefly lifted or adjusted during feeding. Some babies may need increased oxygen during feeding.
What is the minimum flow rate needed?
At least 7 liters per minute for small hoods and 10 liters per minute for large hoods. Lower flows can cause CO2 buildup inside the hood.
How do you know if the oxygen hood is working?
Monitor the baby's oxygen saturation, breathing rate, color, and work of breathing. An oxygen analyzer inside the hood confirms the correct concentration is being delivered.
Can oxygen hoods be used at home?
Rarely. Oxygen hoods require continuous monitoring, oxygen analyzers, and medical supervision. Home oxygen therapy typically uses nasal cannulas instead.
What happens if the hood is too big or too small?
A too-small hood may restrict movement and cause discomfort. A too-large hood requires higher flow rates and makes maintaining stable oxygen concentration difficult. Proper sizing is essential.
Are there alternatives to oxygen hoods?
Yes. Alternatives include nasal cannula, nasal prongs, face masks, CPAP (continuous positive airway pressure), and mechanical ventilation, depending on the baby's needs.
How often should oxygen concentration be checked?
Every 1-2 hours at minimum, and whenever flow rate is adjusted, hood is opened, or baby's condition changes. Continuous monitoring with an oxygen analyzer is recommended.
Important Considerations
- Always follow hospital protocols and manufacturer guidelines
- Document oxygen concentration, flow rate, and baby's response
- Wean oxygen gradually based on saturation and clinical condition
- Use pulse oximetry for continuous monitoring
- Be prepared to escalate to higher respiratory support if needed
- Ask questions and understand why your baby needs oxygen therapy
- Learn the normal oxygen saturation range for your baby
- Understand alarm settings and when to call for help
- Participate in care when appropriate and encouraged by staff
- Keep a positive environment - babies can sense stress
References and Resources
For further reading and detailed medical information, consult:
- American Academy of Pediatrics (AAP) Guidelines on Neonatal Resuscitation
- World Health Organization (WHO) - Oxygen Therapy for Children
- Textbook: Cloherty and Stark's Manual of Neonatal Care
- Textbook: Avery's Diseases of the Newborn
- National Institute for Health and Care Excellence (NICE) Guidelines
- Device manufacturer's instruction manuals and guidelines
Labels: Neonatal-Care