Neonatal head and torso vibration exposure during inter-hospital transfer
File(s)
Author(s)
Type
Journal Article
Abstract
Inter-hospital transport of premature infants is increasingly common, given the centralisation of neonatal intensive care. However, it is known to be associated with anomalously increased morbidity, most notably brain injury, and with increased mortality from multifactorial causes. Surprisingly, there have been relatively few previous studies investigating the levels of mechanical shock and vibration hazard present during this vehicular transport pathway. Using a custom inertial datalogger, and analysis software, we quantify vibration and linear head acceleration. Mounting multiple inertial sensing units on the forehead and torso of neonatal patients and a preterm manikin, and on the chassis of transport incubators over the duration of inter-site transfers, we find that the resonant frequency of the mattress and harness system currently used to secure neonates inside incubators is ~9Hz. This couples to vehicle chassis vibration, increasing vibration exposure to the neonate. The vibration exposure per journey (A(8) using the ISO 2631 standard) was at least 20% of the action point value of current European Union regulations over all 12 neonatal transports studied, reaching 70% in two cases. Direct injury risk from linear head acceleration (HIC15) was negligible. Although the overall hazard was similar, vibration isolation differed substantially between sponge and air mattresses, with a manikin. Using a Global Positioning System datalogger alongside inertial sensors, vibration increased with vehicle speed only above 60 km/h. These preliminary findings suggest there is scope to engineer better systems for transferring sick infants, thus potentially improving their outcomes.
Date Issued
2017-01-05
Date Acceptance
2016-10-13
Citation
Proceedings of the Institution of Mechanical Engineers Part H - Journal of Engineering in Medicine, 2017, 231 (2), pp.99-113
ISSN
0954-4119
Publisher
SAGE Publications (UK and US)
Start Page
99
End Page
113
Journal / Book Title
Proceedings of the Institution of Mechanical Engineers Part H - Journal of Engineering in Medicine
Volume
231
Issue
2
Copyright Statement
© IMechE 2017. Published by Sage Publications.
Subjects
0903 Biomedical Engineering
0913 Mechanical Engineering
Publication Status
Published