Many hospitals have special care units for high-risk newborn infants. In many areas of the United States, infants are transported to such facilities for special care from the hospital in which they were born. Infants may be considered to be at high risk for life-threatening problems if they are of low birth weight or if they have other perinatal problems.

Infants whose lives are at risk require special care considerations in highly specialized NICUs. Here, they are protected from threats to their nutritional status, environmental problems such as changes in their body temperature, and infection by being placed in isolettes with environmental and thermal control and by the practice of meticulous infection control measures.

Infection prevention and control practices are the responsibility of all health care personnel, including the radiographer. The NICU patient, in particular, has an immature immune system and, therefore, is more susceptible to infection. The radiographer must follow and adhere to the pediatric unit’s standard precautions, policies, and procedures. Hand hygiene is the basic important practice that reduces the risk of infection transmission. A surgical scrub, or a 2-minute scrub as for medical asepsis, may be required of all health care personnel entering these nurseries. Personal protective equipment such as gowns, gloves, masks, and eye protection may be required. The technologist must have the proper education and training on pediatric standard precautions for the prevention of the transmission of infection. The prevention of infection includes cleaning the x-ray equipment, which includes the mobile x-ray machine, the image receptors or detectors, gonadal shielding, and right or left markers. The mobile machine must be wiped clean with a disinfectant solution and must be free of dust before entering the nursery. Specific procedures must be followed in regard to the imaging equipment and accessories.

The nurse in charge of the infant’s care must be consulted. The nurse should be asked to assist by positioning and immobilizing the infant. Care must be taken to prevent chilling the infant or dislodging any catheters or tubing while performing the radiographic procedure (Fig. 7-1). The technologist should provide a protective apparel apron to the nurse who is assisting to hold the infant (Fig. 7-2); provide the infant with gonadal shielding when appropriate.

If the radiographer has any sort of respiratory infection or infected cuts on his hands, another technologist should be asked to take the NICU assignment to prevent introduction of infectious microorganisms into the protective environment of the NICU.