Visibility in Varying Light Conditions During Simulated Neonatal Transport

During neonatal transport, specialized pediatric transport teams closely monitor the status of critically ill newborns. Teletransport applications require an appropriate light intensity for the visibility of the neonate, but this must be balanced with safety for sensitive eyes. This simulation study was conducted to determine the amount of light needed to view a neonatal manikin during transport.  Methods: The potential light exposure to the eyes of the neonate was measured using light bars and a photometer in a simulated transport setting with a newborn manikin in a transport incubator. Twelve videos depicting the visibility of the manikin in the incubator were recorded in controlled amounts of light and viewed by experienced medical control physicians (MCPs). Eight neonatologist MCPs participated in a survey.  Results: Based on MCP ratings, the location of the light source for optimal viewing was along the inside upper long edge above the access door. Analysis of the range of desired light intensity showed that the amount of light that reached the patient's eyes (1 to 22.5 lux) was significantly lower than the intensity at the light source (1 to 351 lux) and did not increase linearly with the increasing light intensity.  Conclusion: There was variability in the range of desired light intensity for remote patient monitoring during neonatal transport. More studies on visibility and safety are needed to inform approaches to remote patient monitoring during transports.