VI. Baby Preparation
Skin Prepping Techniques
Skin prepping reduces electrical impedance across the baby’s skin, which allows for better
conductivity of the very small electrical signals that constitute the ABR. Conductivity is enhanced
by moisture, for example skin fluid or saline solution. Conductivity is impeded by dry skin or oil
on the skin.
Skin prepping is not normally required for ALGO screening; however, infants with oily skin or
body hair at the sensor sites typically exhibit higher impedance, and may require prepping in
order to be successfully screened.
Oily skin responds well to cleaning with mild soap and water followed by prepping with
NuPrep
®
gel or other neonatal skin prepping gel.
Dry skin responds well to prepping with saline or NuPrep
®
gel, or a drop of saline under
each sensor.
Warning! Babies with very fragile skin may not respond well to prepping, and should be screened as
close to hospital discharge as possible. Do not prep compromised or irritated skin.
Prepping Tips
Prep the skin by creating some friction, but never using force. Prepping is a learned
technique. Be sure that you are moving the prepping pad over the skin, and not just moving
the skin under your fingers.
Always prep an area slightly larger than the sensor site.
Place infant on his side and tilt head gently forward for easier access to the nape site.
Separate the folds of the skin with one hand and prep with the other.
A drop of saline can help rehydrate slightly dry sensors, and may add enough moisture to
adequately decrease a marginal impedance reading.
If impedance reading is >99 kOhms, ensure that all sensors are attached to the baby and
cable clips are attached to the sensors. Perform an Impedance Check (see Chapter VIII.
Service Manual: Equipment Checks) to rule out a cable problem.
If Nape and Vertex impedance readings are high, prep Common site first.
Note: Alcohol can be effective for babies with very oily or sebaceous skin, but it dries the skin as well. If
alcohol use is permitted, you may need to follow with a wet gauze wash and/or NuPrep gel prepping to
rehydrate the skin.
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