Chapters Transcript Kangaroo™ NTrainer™ How To The Intrainer system 2.0 is the only FDA class 2 biofeedback device designed to help newborns and premature infants with underdeveloped non-nutritive sucking or NNS patterns by providing a gentle oral motor stimulation through a pacifier that reinforces NNS skills. Learn how to deliver an intrainer assessment to determine an infant's NNS skill level over time and provide a therapy session to help develop the oral coordination they need for independent oral feedings. To turn on the intrainer system 2.0, Ensure the system is plugged in. The UPS power button located on the battery is on, and the power switch on the back of the monitor enclosure is flipped to on. Press and hold the button on the front of the monitor to turn on the screen. The device should be plugged in at all times during use and storage. The main screen displays the following features assessment and therapy, select to begin an assessment or therapy session. Data overview select to track an infant's progress and view prior assessment and therapy sessions. Settings, select to adjust screen brightness and volume. Press manage in trainer to manage users, manage patients. Run a utilization report, pair a hand piece, and adjust date and time. Patient icon displays the name of the patient file currently open. Select to switch patient files. Logout icon, select to log out user or to power off the system. To log into the system, enter your unique username and password, then select new or existing patient. To create a new patient file, fill in the patient's information, press save, and confirm the information is correct. To open an existing patient file, type in the first or last name of the patient or patient ID. Select the name of the patient and then press confirm patient if all details are correct. To edit a patient file or mark a patient inactive, go to settings, select manage in trainer, then manage patients to select the desired patient. First, ensure the handpiece tubing connects the monitor enclosure to the handpiece. Second, line up the receiver tube to the handpiece. Next, push down the receiver tube and twist receiver tube to locked position. Attach the soothing pacifier onto the top of the patient receiver tube until the lip is fully covered. From the assessment and therapy tab, select assessment. Confirm the correct pacifier is selected and continue through the prompts to calibrate the machine. Before starting an assessment or therapy session, prepare the patient by swaddling the infant loosely so breathing is unrestricted, and the infant's hands can easily move up to the face or mouth. Use developmental support to position the infant with arms and legs in flexion and hold in side lying feeding position supporting the head, neck, bottom, and legs. Once the infant is settled, gently brush the pacifier on their cheek or lips to encourage a brooding response. Allow the infant time to accept the pacifier. Be sure to keep the handpiece still during assessment. To start the assessment, use the button on the handpiece or the start button on the screen. The wave form provides a visual representation of the infant's full oral motor activity. Peaks in the wave form indicate sucking bursts followed by pauses to breathe. An ideal wave form will have consistently spaced bursts and pauses with similar peak heights. Progress through the entire assessment while continuing to monitor the infant for any signs of stress or intolerance. Pause the session to support the infant as needed by using the button on the handpiece or the pause button on the screen. When the assessment is complete, select the patient's state and confirm. Next, fill in any relevant notes about the session. Review the infant's assessment on the review assessment screen. To view the full waveform, pan its length and zoom in and out by using the plus or minus buttons. Metrics will populate to help you make an objective assessment of the infant's non-nutritive sucking skills. As a recommendation, an assessment may be provided every 3 to 7 days to track progress. To run a therapy session, press therapy from the assessment and therapy tab. Select the correct soothy pacifier and therapy type. Standard therapy is most common. Follow the prompts to calibrate the system. Gently elicit a rooting response with the pacifier. Once the infant has the pacifier in their mouth, the therapy session can begin by pressing the button on the handpiece or the start button on the screen. The pacifier will gently pulse and contract 6 times, followed by a 2 2nd pause, mimicking the non-nutritive sucking pattern of a healthy full-term infant. The pulse acts on the nerves in the infant's mouth, sending messages to the brain to suck in a more coordinated pattern. Be sure to keep the hand piece still during therapy. The wave form on the screen shows the pacifier's movements and will not respond to what the infant is doing. If the infant falls asleep, therapy can continue. It is recommended that therapy be done during gavage feedings or prior to oral feedings 2 to 4 times per day until oral feedings are established as determined by the healthcare professional. During in trainer therapy sessions, the healthcare provider delivering the therapy can provide bedside education on oral feeding readiness and help parents identify their infants specific feeding cues. Parents can also be taught how to hold their infant in appropriate feeding positions. To view a patient's assessment and therapy history, press data overview. Select this option to view multiple assessments and select dates to compare. Select this option to view full screen. Always log out between sessions to ensure patient confidentiality and to prevent non-users' access to protected health information. To log out, select the logout icon in the bottom left corner of the screen and confirm log out. To power off the device, use the same logout icon and select power off. The end Trainer system 2.0 should be cleaned after every patient use. The patient receiver tubes are designed for single patient multiple use. All patient receiver tubes should be disposed after patient discharge. See the instructions for use for appropriate cleaning solutions. Please refer to your Quick start guides or instructions for use supplied with this device for indications, suggested procedures, warnings and precautions. For more information, reach out to your Cardinal health representative or visit cardinalhealth.com/intrainerssystem 2.0. Created by