med 18

(3) Connect the cap connector tubes to the main

hose using the male/female connectors.

(4) After all the tasks are complete, press Next.

f. Setting up fill cycle, for the setup wizard displays

(1) Check the hose and tube connections, then

start filling the system.

Table 45.1 Recommended Initial Cap

Water Temperatures

Infant Size Infant Weight

Recommended Initial Cap

Water Temperature

Small ≥1.8–<2.5 kg 12–15°C

Medium 2.5–4 kg 10–12°C

Large >4 kg 8–10°C

Table 45.2 Determination of Cap Size

Cap Size Infant Weight Head Circumference

Small ≥1.8–<2.5 kg <32 cm

Medium 2.5–4 kg 32–37 cm

Large >4 kg >37 cm

Chapter 45 ■ Brain and Whole Body Cooling 329

A

B C

Fig. 45.5. Water cap (A), Water cap (B), and Water cap retainer (C) placement on the infant.

A: Rocking, massaging, and inverting the water cap to remove any air bubbles from the crevices.

B: Securing the water cap on the infant’s head. C: Securing the water cap retainer over the water cap.

(2) After the system has filled, gently rock, massage,

and invert the water cap to remove any air

bubbles from the cap crevices (Fig. 45.5 A).

(3) After the tasks are complete, touch Next.

g. Placing Caps and Shield, for the setup wizard displays

(1) Position the water cap (Fig. 45.5B) on the

infant’s head, with the opening anterior, centered on the hairline and with the forehead

exposed.

(2) Position the ear cutouts above the ears.

(3) Place the ear straps under the ears.

(4) Route the scalp temperature sensor wire out of

the cap, over the infant’s forehead.

(5) Place the cap connector tubes in the cap tube

support.

(6) Place the blue water cap retainer (Fig. 45.5C)

over the water cap.

(7) Slide the chin strap of the water cap through

the ear straps of both water cap and the water

cap retainer, and fasten the right and left

Velcro fasteners.

(8) Place the large Velcro fastener on top of the

infant’s head, in front of the red cap tube, and

the small Velcro fastener between the cap

tubes.

(9) Place the silver insulating cap (Fig. 45.6A)

over the water cap retainer.

(10) Secure the three Velcro fasteners on the inside

of the water cap retainer to the patches on the

inside of the insulating cap.

(11) Secure the Velcro fastener of the insulating

cap in front of the cap connect tubes.

(12) Place the heat shield over the infant’s head,

aligning with the chin, and resting evenly and

directly on the mattress (Fig. 45.6B).

(13) After each task is complete, touch Cool to start the

system’s cooling timer and main display screen.

h. Once the rectal temperature reaches 35.5°C, switch

on the radiant warmer.

i. Set the servo control temperature on the radiant

warmer to 37°C.

j. Adjust the water cap temperature to maintain the

rectal temperature between 34°C and 35°C.

k. Continue cooling for 72 hours.

l. Commence rewarming after 72 hours and follow

instructions on the screen for automated rewarming

at 0.5°C/h. Switch off the cooling unit.