NICU Nightmare

Flames in the bed? A Minnesota newborn was badly burned, especially about the face and neck when a fire started in his oxyhood. The baby was already experiencing respiratory distress and likely has heat injury to the airways as well. How awful for the baby and the family! Only quick reaction on the part of the nurses in the room spared the baby further injury.

The original story linked to this post is no longer available.

An oxyhood is a fairly simple device which consists of a Plexiglas or plastic "hood" which encloses the baby's head and allows an oxygen enriched, humidified environment to be provided to an infant.

The baby's head stays inside the "hood" with the large opening over the neck. Oxygen is introduced via the hollow tube in the left of this image - generally by way of a corrugated plastic tubing. In some models, the lid can be removed to allow access to the baby without losing all the oxygen (much of it, but not all). In others, you have to remove the entire "hood" to reach the baby's face.

We used to use oxyhoods quite often, but have gone over to nasal cannulas instead (ease of use, ease of cleaning, the ability to provide enough flow to help stent the airways among other reasons). Fear of fire is NOT one of the reasons we switched. Quite honestly, it never occurred to me that this could happen -- that it is technically possible, yes. That it could actually happen - no.

The last 2 times I've used an oxyhood in the NICU, it was only to provide humidity with no added oxygen. AND it was in a radiant warmer bed which could potentially be described as an "open topped bassinet under a warmer." There are many brands and styles of warmer beds as well.



I hope that the hospital where the fire occurred will share the results of their investigation. I have a personal theory about how this might have happened and it would not be specific to the brand or style of oxyhood or warmer bed. In fact, an oxyhood wouldn't be needed at all in my personal nightmare theory. Speculation is useless, though.

Facts are necessary - not only to avoid any possibility of a repeat, but to ensure that a useful piece of equipment isn't needlessly discarded. If we believe that warmer beds or oxyhoods are the problem and discard either (or both) we may not eliminate the actual risk. If we presume that an equipment malfunction (or misuse) is to blame, we may not take appropriate precautions either.