Technology has changed so much in the last 50 years.
When I was in school for my bachelor’s degree in 1986, all papers were typed on a typewriter. If you wanted reference material, you went to the library with lots of change, or a card filled with money, to copy pages of the journal.
By the time I was in my master’s program in 1990, we all had personal desktop computers. But the technology was not nearly what it is today! In fact, I’ve heard it said that computer technology is outdated within six months (that explains all the updates we constantly need to download!).
Can you imagine not being able to e-mail or text (the more modern method of communication)? Cordless phones weren’t even available in the 1950s and 60s, maybe by the 70s for many folks. In the 60s, and at least early 70s, many of us had “party lines,” where you could listen to your neighbors talk if you picked up the phone.
For those of you born in the 1950s, 60s, or 70s, cell phones didn’t even exist. Fast forward to today, and they are practically miniature computers!
Technology in healthcare
Technology in healthcare has ballooned over the last 30 years as well.
Ventilators were introduced to the NICU in the 1970s. These were adult ventilator models modified to deliver ventilation to tiny lungs (with resulting complications like pneumothorax being very common). Oxygen concentrations were measured hourly by withdrawing air from the ventilator circuit and injecting it into an analyzer. Analyzers in every ventilator circuit or oxygen delivery mode came later!
Pulse oximeters came much later, with transcutaneous monitors for oxygen and carbon dioxide levels available first, but not as accurate and with risks like burns to the skin.
And in just the last 10 years, computerized charting has come into play, with both advantages and disadvantages for patient care.
Early feeding delivery technology
Feeding delivery has changed as well. In the early days, for babies not able to bottle feed, most feeds were given by gravity with few infants getting fed via pump.
The early feeding pumps were the same as IV pumps. In fact, many places are still using the same pump for IV fluids, medications, and feedings.
The early feeding pumps were gravity driven with inaccurate flow rates. Setting options only included a rate. For feeds, this didn’t matter too much – a feeding intended to be given over 30 minutes that is actually delivered in 25 minutes or 35 minutes doesn’t make too much difference in the well-being of the infant or in outcomes. However, since these were also used for medications, it could certainly make a difference in medication dosing and response!
Improvements over the years
The accuracy of syringe pumps has improved significantly. Newer pumps have extremely accurate infusion rates and have many safe-guards in delivery.
Most pumps available in the U.S., even syringe pumps, now have the ability to be programmed with safety libraries and can be set to infuse at a given rate per hour, volume over time, and other modalities.
In some cases, large volume feeding pumps are used in the NICU as well as at home. The technology in these pumps has changed very little and are useful in home care and cases where 24-hour feeding volumes are greater than 60 Ml, and low, accurate infusion rates are not needed.
Over the last five years or so, pumps specifically for feedings have been rolled out for use.
The point to these pumps is that they are visually different than pumps used for IV infusions. They require less technology, and are less expensive than other “smart” pumps with drug libraries and the safety guards necessary for medication administration.
These pumps may provide some additional safety in preventing tubing misconnections. Additionally, it is a less expensive way to beef up pump inventory without unnecessary expense. However, not all feeding pumps are created equal, so be sure to evaluate any pump carefully before purchase to ensure it meets your clinical needs.
Just as the technology has changed, so too must we. Thanks to innovations in technology, the medical industry can provide improved care for our specialized patient population.
And that’s progress.
Learn more about the Medela Enteral Feeding Pump,
made specifically for enteral feeding in the NICU.