Patent Publication Number: US-2017347960-A1

Title: Mobile newborn care bed and methods of newborn care

Description:
BACKGROUND 
     The present disclosure relates to the field of infant care, and more specifically to systems and methods for providing diagnosis and therapy to newborn infants. 
     At the time of birth, infants need immediate assessment and care, including assessment of heart and respiratory function. Infant patients can experience relatively rapid changes in condition, especially immediately after birth. Depending on the infant&#39;s condition, various therapies may be provided, including resuscitation or other respiratory care. Further, infants also often require a heated environment to prevent cold stress. Accordingly, the use of radiant warmers and/or incubators for maintaining environmental conditions suitable for an infant is common immediately after an infant&#39;s birth. Conventional warming devices comprise a bassinet provided underneath a warming element, which is suspended directly over the infant. 
     According to long-standing care standards, an infant&#39;s umbilical cord was cut immediately upon delivery and the infant was removed from the mother to check vital signs and provide any needed therapy, such as respiratory therapy. In such instances, babies were removed from the delivery location and placed on a bassinet or infant bed, often containing a radiant warmer. Currently available infant beds and radiant warmers are configured to be positioned in a corner of a delivery room so as not to crowd the space next to the mother. Moreover, most infant care beds and radiant warmers are one, integrated, bulky device, where the bassinette is built into the warmer. Resuscitation equipment and/or monitoring equipment, if any, is positioned near the infant bed/radiant warmer away from the delivery location. 
     SUMMARY 
     This Summary is provided to introduce a selection of concepts that are further described below in the Detailed Description. This Summary is not intended to identify key or essential features of the claimed subject matter, nor is it intended to be used as an aid in limiting the scope of the claimed subject matter. 
     In one embodiment a mobile newborn care bed is configured to be positioned at a delivery location of an infant includes a bassinet containing a mattress for receiving the infant and a frame that supports the bassinet. At least two capacitive sensors are incorporated in the mattress that record cardiac signals, and an on-bed computing system is configured to receive the cardiac signals and determine a heart rate for the infant. A battery supported by the frame powers the on-bed computing system, and a digital display is communicatively connected to the on-bed computing system and displays the heart rate. 
     One embodiment of a method of monitoring a newborn infant includes recording cardiac signals from the infant with two or more capacitive sensors incorporated in the mattress. The recorded cardiac signals are received at an on-bed computing system of the mobile newborn care bed, and a heart rate is determined in the on-bed computing system based on the cardiac signals. The heart rate is then displayed on a digital display communicatively connected to the on-bed computing system. 
     Another embodiment of a mobile newborn care bed is configured to be positioned at a delivery location of a newborn infant includes a bassinet containing a mattress that supports the infant and a frame that supports the bassinet. The mobile newborn care bed further includes an on-bed computing system comprising a processor, a flow sensor communicatively connected to the on-bed computing system, and a CO 2  sensor communicatively connected to the on-bed computing system. A resuscitation module is executable on the processor to receive a flow measurement measured by the flow sensor and a CO 2  measurement measured by the CO 2  sensor and determine one or more respiration parameters for the infant. A digital display is communicatively connected to the on-bed computing system and displays one or more of the respiration parameters. 
     A method of providing resuscitative care to a newborn infant includes measuring a gas flow with a flow sensor in a breathing circuit for the infant. The flow measurement is communicated to an on-bed computing system. An expired CO 2  is measured with a CO 2  sensor in the breathing circuit for the infant, and the CO 2  measurement is communicated to the on-bed computing system. One or more respiration parameters are determined for the infant with the on-bed computing system based on at least the flow measurement and the CO 2  measurement. One or more of the respiration parameters may then be displayed on a digital display communicatively connected to the on-bed computing system. 
     Various other features, objects, and advantages of the invention will be made apparent from the following description taken together with the drawings. 
    
    
     
       BRIEF DESCRIPTION OF THE DRAWINGS 
       The present disclosure is described with reference to the following Figures. 
         FIG. 1  is a schematic diagram of one embodiment of a mobile newborn care bed and separate, freestanding warmer configured to pair with the mobile newborn care bed. 
         FIG. 2  is a schematic system diagram of an on-bed computing system and sensor elements for a mobile newborn care bed, as well as a hub device and host network communicatively connected to the on-bed computing system. 
         FIG. 3  is a schematic diagram depicting one embodiment of an on-bed computing system. 
         FIG. 4  is a schematic diagram depicting one embodiment of a hub computing system. 
         FIG. 5  depicts one embodiment of a method of monitoring a newborn infant. 
         FIG. 6  depicts one embodiment of a method of providing resuscitative care to a newborn infant. 
     
    
    
     DETAILED DESCRIPTION 
     Newborn birth and delivery care standards are trending towards maintaining the infant at the birthing site to the extent possible in order to allow delayed cord clamping and cutting for several minutes so that the blood in the umbilical cord is transferred to the baby. Accordingly, through their experimentation and research in the relevant field, the present inventors have recognized that such delated cord clamping and other modern care standards for newborn infants immediately after birth have made current radiant warmer and resuscitation platform technology obsolete. The inventors have recognized that a device is needed to provide diagnosis and therapy to a newborn infant next to the mother and at the site of birth so that such therapy can be administered before and/or during the cord clamping. Further, the inventors have recognized that devices and systems are needed that provide monitoring and resuscitation care for infants easily and with minimal attachment of devices to the baby. Further, the inventors have recognized that devices and systems are needed that provide immediate and accessible display of multiple relevant vital parameters, such as cardiac and respiration parameters, to clinicians providing care, and also seamless transmission and storage and of such data to the patient&#39;s healthcare records. 
     In light of their experimentation and research in the relevant field, the present inventors have further recognized that clinicians providing care to infants at birth are often seeking more guidance for providing safe respiratory and resuscitative care to infants, such as to reduce barotrauma and volutrauma, and to reduce or delay use of invasive ventilation as much as possible in the delivery room. In light of these problems and needs in the relevant field recognized by the inventors, they developed the disclosed mobile newborn care bed including built-in, non-contact cardiac monitoring and non-invasive respiratory therapy devices for providing positive pressure ventilation and/or continuous positive airway pressure. 
     In further view of their recognition of problems and needs in the relevant field, the inventors developed the mobile newborn care bed and associated methods of infant monitoring and care. The mobile newborn care bed is configured to be positioned at a delivery location of an infant and is equipped with built-in diagnosis and therapy equipment and systems to enable a clinician to provide monitoring and/or resuscitative care to an infant immediately upon birth, including before and during cord clamp. 
       FIG. 1  depicts one embodiment of a mobile newborn care bed  10 , which is relatively small and agile and able to be positioned at a delivery location of an infant. The mobile newborn care bed has a bassinet  12  containing a mattress  18  on which the infant  2  is placed. The mattress  18  is preferably a flat or slightly concave cushioned surface, but can be any flat or curved surface capable of receiving the infant  2 . A frame  52  is underneath the bassinet  12  and supports the bassinet  12 . The frame includes a base frame portion  52   a  connecting to one or more wheels  54  that allow the mobile newborn care bed  10  to be easily moved. The frame  52  also includes a vertical frame portion  52   b  that elevates and attaches to the bassinet  12 . In various embodiments, the vertical frame portion  52   b  may be adjustable to adjust the height of the bassinet  12 . The base frame portion  52   a  may be configured to support various elements comprising part of the mobile newborn care bed  10 , such as one or more batteries  48  and/or gas supply tanks  44 . 
     In the depicted embodiment, the bassinet  12  includes a bottom portion  12   a  supporting the mattress  18 , and also includes a head portion  12   b  adjacent to one side of the mattress  18  and a foot portion  12   c  a pulse oximeter device  22 . In other embodiments, such devices may be housed or incorporated at other locations on the mobile newborn care bed  10  or may be provided separately but in conjunction with the mobile newborn care bed  10 . In still other embodiments, such devices may be separately housed and attachable to or otherwise associated with the bassinet  12  and/or frame  52 . 
     In certain embodiments, the bassinet  12  may include a rigid base plate  14  immediately underneath and supporting the weight of the mattress  18 . At least one load cell  15  is positioned under the base plate in order to sense a load of the infant and provide a load measurement  84  from which a weight can be calculated. Specifically, the load cell(s)  15  and associated electronic weighing system may be calibrated to the weight of the mattress  18  so that the weight of an infant  2  can be determined immediately upon placing the infant  2  on the mattress  18 . Furthermore, other parameters may also be determined based on continuous load measurement by the one or more load cells  15 , including whether the infant is breathing or is experiencing an apnea event. In one embodiment discussed in more detail hereinbelow, the load measurements  84  may be received and processed by a load module  74 , which is a software module stored on and executed by the on-bed computing system  100  to determine weight  85 , and detect and apnea event and generate an apnea event notification  86 . 
     The mobile newborn care bed  10  may further include sensors incorporated into the mattress  18  to measure cardiac signals from the infant  2  when the infant is placed on the mattress  18 . Specifically, two or more capacitive sensors  20  may be incorporated into a top portion of the mattress  18 . For example, the capacitive sensors  20  may be metal plates positioned on a top surface  18   a  of the mattress  18 , or just beneath a mattress cover, such as between a cushion filling of the infant mattress  18  and a cover for the cushion. In various other embodiments, the capacitive sensors  20  may be embedded close to the top surface  18   a  of the mattress, such as imbedded in a foam or other cushion material of the mattress. In still other embodiments, two or more capacitive sensors  20  may be integrated into or fixed to a cover or casing of the mattress  18 . The two or more capacitive sensors  20  record the time varying bioelectric field produced by the infant&#39;s beating heart, which imparts corresponding changes on the metal plate by capacitive transmission. Accordingly, the capacitive sensors  20  detect and measure the electric field without any direct physical contact between the sensors and the infant&#39;s skin, and no electrically conducting path between the sensors  20  and the infant is needed. 
     Thereby, cardiac signals  81  may be recorded from the infant  2  immediately upon placing the infant  2  on the mattress  18 , and can be continually recorded while the infant  2  remains on the mattress without any need for attaching physical ECG electrodes to the infant&#39;s skin. In one exemplary embodiment, the mattress  18  may incorporate a grid of capacitive sensors  20 , such as a grid of  4 ,  6 ,  9 ,  12 , or more capacitive sensors  20 , various ones of which may provide the best measurement of the bioelectric fields and thus cardiac signals  81  for the infant, depending on the position of the infant  2  on the mattress  18 . The capacitive sensors  20  may be connected to the on-bed computing system  100  by leadwires  21 , which may be embedded in the cushion of the mattress  18  or in a casing thereof. The leadwires  21  may have a connector that connects to a mating connector on the bassinet  12  of the mobile newborn care bed  10 , or by wireless means via a wireless transmitter in the mattress  18  and corresponding wireless receiver incorporated into the bassinet  12 . 
     A heart rate and other cardiac information  82  may be determined from the capacitively measured cardiac signals  81 . The capacitive sensors  20  may connect to a signal processing module including hardware and software to receive the measured signals from the capacitive sensors  20  and create cardiac signals  81  that may be used by the system for medical assessment and diagnosis purposes. Such signal processing circuitry and software may include an analog to digital converter, filters, amplifiers, and the like. Such circuitry and software may be provided in a stand alone module contained on the mobile newborn care bed  10  and connecting to the on-bed computing system  100 , or may be incorporated into the on-bed computing system  100  as described further herein. 
     In the depicted embodiment, the on-bed computing system  100  receives the cardiac signals  81  ( FIG. 3 ) and processes the cardiac potential measurements to determine cardiac information  82 . For example, the on-bed computing system  100  may have a software module for processing the digitized cardiac signals  81 , a cardiac module  70 , to determine various cardiac information  82  about the cardiac health of the infant  2 , such as heart rate and/or wave morphology information. In one embodiment, the cardiac module  70  includes instructions executable to detect R-waves within the cardiac signals  81 , from which the heart rate can be determined. 
     The cardiac module  70  may further be configured to detect a bradycardia event based on the cardiac potential measurements, which will be recognized by a person having ordinary skill in the art as important information for determining the health and well-being of an infant  2  within its first few hours and days after birth. For instance, as explained in more detail hereinbelow, the cardiac module  70  may continually determine heart rate and detect a bradycardia event when the heart rate is below a predetermined threshold value, and then generate a bradycardia event notification  83 . The cardiac information  82  and/or bradycardia event notification  83  may then be transmitted from the on-bed computing system  100  to a hub device  68  and/or to a host network  76 , such as to a network of a hospital, for storage in a patient medical record database  78 . The cardiac module  70  may further store the cardiac information  82  and/or bradycardia event notifications  83  in storage system  104  of the on-bed computing system  100 , and may also provide further cardiac assessment functions, such as heart rate trending assessment or other time varying data to plot or otherwise convey variance of the heart rate or other cardiac information  82  over a period of time. 
     The on-bed computing system  100  may be communicatively connected (i.e. connected by physical or wireless means so as to be able to communicate information to or with another device) to a digital display  46  to communicate display commands thereto, such as to display the cardiac information  82  and/or respiratory information  96  thereon. Accordingly, the digital display  46  associated with the mobile newborn care bed  10  may display the infant&#39;s heart rate and/or other cardiac information  82  to a clinician while the clinician is providing medical care to the infant  2 . Likewise, the on-bed computing system  100  may control the digital display  46  to display notifications of poor cardiac health or cardiac events, such as to provide a visual alert when a bradycardia event is detected. 
     The digital display  46  may be any digital display device known in the art and may be fixed to the bassinet  12 , such as to the head portion  12   b  of the bassinet  12 , in a way that is visible to clinicians providing care to the infant  2 . Alternatively, the digital display  46  may be a separable or completely separate device from the bassinet  12 , such as a tablet or mobile computer. In still other embodiments, the digital display  46  may be a display of another device networked with the mobile infant care bed  10 , such as the display of the fetal monitor. 
     As described herein, the digital display  46  may be controlled by the on-bed computing system  100  to provide various health information for the infant, including the respiratory information  96 , cardiac information  82 , weight  85 , arterial oxygen saturation (SpO 2 ) value  88 , temperature measurement  94 , or any other relevant value. Additionally, the digital display  46  may provide a user input device, such as via a touchscreen, to provide control input to the on-bed computing system  100  and/or any other system or device on the mobile newborn care bed  10 . Accordingly, in various embodiments, multiple systems and devices on or incorporated into the mobile newborn care bed may connect directly to the digital display  46  and be capable of providing control signals to the digital display  46 . For example, the ventilator device  40  may connect to the digital display  46  and the digital display  46  may provide a user interface to control the ventilator device  40 . Such connectivity may be provided directly between the ventilator device  40  and the digital display  46 , or may be routed through the on-bed computing system  100 , which may provide a central control for all devices on the mobile newborn care bed, including the ventilator device  40 . 
     The mobile newborn care bed  10  may further include a pulse oximeter sensor device, including an SpO 2  sensor  23  attachable to the infant and connecting to a pulse oximeter  22  that determines an SpO 2  value  88 , and transmits the SpO 2  value  88  to the on-bed computing system  100 . The pulse oximeter  22  may transmit the SpO 2  value by wired or wireless means, various examples of which are provided herein. The pulse oximeter  22  may be incorporated into the bassinet  12 , such as in the foot portion  12   c  of the bassinet  12  as depicted in  FIG. 1 . In other embodiments, the pulse oximeter may be a separate device that may be kept in proximity of the bassinet  12  and may be wirelessly paired with the on-bed computing system  100 . The SpO 2  sensor  23  may be any sensor device capable of measuring the infant&#39;s peripheral oxygen saturation, many varieties of which are well-known in the relevant art, such as a disposable adhesive sensor device configured to wrap around the infant&#39;s foot. The SpO 2  sensor  23  may include a wire connecting to the pulse oximeter  22 . In still other embodiments, the physical circuitry and software of the pulse oximeter  22  may be incorporated within the on-bed computing system  100 , and thus the SpO 2  sensor  23  may communicate measurements related to O 2  saturation directly to the on-bed computing system  100  for determination of SpO 2  values  88  for the infant  2 . Upon receipt or determination of the SpO 2  value  88  for the infant  2 , the on-bed computing system  100  may transmit the SpO 2  value  88  to the hub device  68 , or directly to a host network  76 . Further, the on-bed computing system  100  may send control signals to the digital display  46  in order to display the SpO 2  value  88  thereon. Alternatively or additionally, the mobile newborn care bed  10  may incorporate a co-oximeter device that measures and determines one or more of carboxyhemoglobin saturation (SpCO), methemoglobin saturation (SpMet), and/or total hemoglobin concentration (g/dl SpHb). For instance, the co-oximeter device may be a Rainbow SET Pulse CO-Oximeter by Masimo Corporation of Irvine, Calif. 
     The mobile newborn care bed  10  further includes and incorporates devices and systems for providing resuscitation and other respiratory therapy to an infant  2  in need of such intervention. A person having ordinary skill in the relevant art will know that it is not uncommon for a newborn infant  2  to need some sort of respiratory care or resuscitation immediately after birth, and such care needs to be provided at the location of birth if cord clamping is to be delayed so that the infant  2  can receive the cord blood. Accordingly, the mobile newborn care bed, which as described above, is configured to be positioned at the delivery location of an infant, is equipped with a breathing circuit that includes a ventilator device  40 , such as a continuous positive airway pressure (CPAP) device, a positive pressure ventilation (PPV) device, or a positive end-expiratory pressure (PEEP) device (or a ventilator device providing all three respiratory therapies). In the depicted embodiment, the ventilator device  40  receives a gas supply from supply tube  42  connected to gas supply tank  44 , which is supported on the base frame portion  52   a . The ventilator device  40  regulates the gas supply as appropriate to provide resuscitative or respiratory assistance to the infant  2 . The ventilator device  40  connects to the breathing tube  38 , which supplies gas to the infant through a mask  36  applied over the infant&#39;s nose and mouth, thereby forming breathing circuit  25 . In other embodiments, the breathing tube  38  may deliver gas to the infant  2  via a nasal cannula or by some other delivery means. 
     The breathing circuit  25  is equipped with sensors for measuring parameters relevant to the infant&#39;s respiration, which may be provided in the mask  36 , breathing tube  38 , or at the connection of the mask  36  and the breathing tube  38 . Various sensors may be incorporated into the breathing circuit  25 , such as a CO 2  sensor  28  that measures CO 2  in gas expired by the infant  2 , an O 2  sensor  27  that measures O 2  in gas inspired by the infant  2 , a flow sensor  29  that measures gas flow within the breathing circuit  25 , a pressure sensor  30  that measures pressure within the breathing circuit  25 , or a temperature sensor  31  measuring temperature of expired and/or inspired gas within the breathing circuit  25 . Each of the one or more aforementioned sensors may be contained in a respiration sensor device  26 , such as a device positioned between the mask  36  and the breathing tube  38 . For instance, the respiration sensor device  26  may be configured to communicate with one or more devices on the mobile newborn care bed  10 , including the ventilator device  40  and/or the on-bed computing system  100 . The respiration sensor device  26  may communicate wirelessly or by wires that extend to a receiving connector in the bassinet  12  (such as extending along and/or embedded into the breathing tube  38 ), or otherwise electrically connect to the ventilator device  40 , the on-bed computing system  100 , or another system that processes the sensor measurements. In other embodiments, the respiration sensor device  26  may communication the measurements to a wireless receiver associated with the ventilator device  40 , the on-bed computing system  100 , or another system that processes the sensor measurements. 
       FIG. 2  schematically depicts an exemplary embodiment of the respiration sensor device  26  containing O 2  sensor  27  supplying O 2  measurement  90 , CO 2  sensor  28  supplying CO 2  measurement  91 , flow sensor  29  supplying flow measurement  92 , pressure sensor  30  supplying pressure measurement  93 , and temperature sensor  31  supplying temperature measurement  94 . The mobile newborn care bed  10  may be configured with any one of the aforementioned sensors to provide respiration parameter measurements from the breathing circuit providing breathing gas to the infant  2 , and such respiration parameter measurements may include, but are not limited to, the aforementioned measurements. The respiration sensor device  26  further includes a processor  33  that receives the measurements from each of the sensors  27 - 31  and communicates those measurements via wireless communication protocol to the on-bed computing system  100  through wireless receiver/transmitter  34 . Transmissions from the wireless receiver/transmitter  34  are received by a wireless receiver/transmitter  35  associated with the on-bed computing system  100 . The wireless receiver/transmitters  34  and  35  may communicate via any wireless protocol, and relatively short range protocols may be especially useful, such as Bluetooth, Bluetooth low energy (BLE), ANT, ZigBee, or a near field communication (NFC) protocol. 
     The respiration sensor device  26  may be configured to connect between the mask  36  and the breathing tube  38 , and thus may have appropriate connecting means on either end to facilitate such connection within the breathing circuit  25 . In another embodiment, the respiration sensor device  26  may be incorporated into the mask  36 . In still other embodiments, each of the sensors  27 - 31  may be incorporated separately into the breathing circuit  25 , such as into the mask  36 , and each may communicate separately with the on-bed computing system  100  or other system configured to process the respiration related measurements. 
     Referring to  FIGS. 2 and 3 , the on-bed computing system  100  may include a software module stored in memory and executable on a processor  106  within the on-bed computing system  100 —i.e., resuscitation module  72 —configured to process one or more of the respiration parameter measurements  90 - 94  to generate respiratory information  96  regarding the respiratory status of the infant  2 . For example, the resuscitation module  72  may determine respiratory information  96  including an inspired O 2  indicator, such as a fraction of inspired oxygen (FiO 2 ) value. Alternatively or additionally, respiratory information  96  determined by the resuscitation module  72  may include an end title CO 2  (etCO 2 ) based on the CO 2  measurements  91 , title volume based on the flow measurements  92 , and/or intake air pressure based on the pressure measurements  93 . Alternatively or additionally, the resuscitation module  72  may utilize the temperature measurements  94  to determine the temperature of the inspired air and/or to determine information about the temperature of the infant  2 . Any one of the aforementioned values may be included in the respiratory information  96  outputted by the resuscitation module  72 , and such respiratory information  96  may be transmitted to the hub device  68  and/or the host network  76  for storage in the infant&#39;s medical record in database  78 . Alternatively or additionally, some or all of the respiratory information  96  may be displayed on the digital display  46 . In other embodiments, the resuscitation module  72  may be stored in memory and executable on a processor of the ventilator device  40 , which may then communicate the respiratory information  96  to the on-bed computing system  100 . 
     As shown in  FIG. 1 , the mobile newborn care bed  10  may include a battery  48  to power the various devices thereon, including some or all of the various sensing devices, the on-bed computing system  100 , the ventilator device  40 , and/or the digital display  46 . The battery  48  may be positioned on the base frame portion  52   a , for example, and in such a location to be easily accessed in order to recharge or replace the battery  48 . The charge status of the battery  48  may be monitored by a power control module, such as may be provided separately from and in communication with, or otherwise incorporated into, the on-bed computing system  100 . Further, the on-bed computing system  100  may provide a battery status notification, such as on digital display  46 , regarding the charge of the battery  48  on the digital display  46  so that a clinician or other user will be able to determine the charge level of the battery  48 . 
     The mobile newborn care bed  10  may be further configured to physically and/or wirelessly connect to a freestanding radiant warmer  60  to provide infant warming. For example, the radiant warmer  60  may be positioned away from the delivery location and the mobile newborn care bed  10  may be moved over to the radiant warmer  60  once the umbilical cord has been cut and the infant  2  can be moved away from the mother. The radiant warmer  60  may include a warming element  62 , several of which are known and are utilized in the relevant art. The warming element  62  is suspended at an appropriate height and angle above the mobile newborn care bed  10  when the mobile newborn care bed  10  is moved to a predetermined location with respect to the radiant warmer  60 , such as immediately adjacent to and/or connected to the front of the radiant warmer  60 . 
     The radiant warmer  60  may include a base frame portion  64   a  and a vertical portion  64   b . The vertical portion  64   b  may provide connection and support means for various electronic and/or electric elements, including the warming element  62  and/or a hub device  68  and hub display  66 . The radiant warmer  60  may include reciprocal latching means  59  configured to connect to latching means  58  on the mobile newborn care bed  10 . Accordingly, the mobile newborn care bed may be securely yet removably attached to the radiant warmer  60 . For example, the reciprocal latching means  59  may be provided on a base frame portion  64   a  of the radiant warmer  60  at a location that conveniently connects to the base frame portion  52   a  of the mobile newborn care bed  10 . The base frame portion  64   a  of the radiant warmer  60  may be equipped with wheels  65 , and thus the radiant warmer  60  may be moved, and also the mobile newborn care bed  10  and radiant warmer  60  may be movable as a connected unit. 
     The radiant warmer  60  may be powered by a battery and/or by main electric power, such as through an AC wall outlet. Further, such power may be supplied to one or more devices on the mobile newborn care bed  10  when it is attached to the radiant warmer  60 . For example, power transfer may occur from the radiant warmer  60  to the battery  48  in order to charge the battery  48 . In just one embodiment, such power transfer connection may be provided through the latching means  58  and  59  connecting the respective devices. 
     Alternatively or additionally to the radiant warmer  60 , the mattress  18  of the mobile newborn care bed  10  may be heated, such as by one or more heating elements  50  incorporated therein. The heating elements  50  may be any of various heating element-types known in the art, such as heating wires or coils commonly incorporated in electric heating blankets, flexible carbon-fiber heating tape, or heated water circulated through flexible coils. The heating elements  50  may be powered and controlled by a heating control unit  49 , which may be incorporated into the mattress  18  or other location on the bassinet  12 , with a power connection to the bassinet  12  to obtain power from the battery  48  or other power source. The heating control unit  49  may control the heating element(s)  50  based on input from one or more temperature sensors  57  placed on or adjacent to the heating element(s)  50 , such as on or embedded in the top surface  18   a  of the mattress  18 , to sense the temperature of the heating elements. For example, the heating control unit  49  may control the heating element(s)  50  heat the mattress  18  to approximately 98.6 degrees so that placing the infant  2  on the mattress  18  does not contribute to cold stress experienced by the baby. Alternatively, the mattress  18  may be heated to slightly above body temperature, such as to 90 degrees, to warm the infant  2 . The heating control unit  49  may communicate with the on-bed computing system  100 , and the digital display  46  may provide a user interface for the heating control unit  49 , such as to control the temperature of the mattress  18  and/or to display error messages or alerts from the heating control unit  49  regarding the function of the heating system for the mattress  18 . 
     As illustrated schematically in  FIG. 2 , the on-bed computing system  100  may connect wirelessly to hub device  68 , which may in turn connect wirelessly to host network  76 . The hub device  68  may be on the radiant warmer  60  as shown in  FIG. 1  or may be positioned at any location within the communication distance of the mobile newborn care bed  10 . Alternatively, the hub device  68  may be provided by a mobile computing device, such as a laptop, tablet, smart phone, or the like. For example, a software application may be provided to allow a clinician&#39;s tablet or smart phone to act as the hub device  68 . In still other embodiments, the hub device  68  may be a fetal monitoring unit, and thus the mobile newborn care bed  10  may communicate the cardiac information, respiratory information, etc. to the fetal monitoring unit for transmission to the host network  76 . In such an embodiment, the fetal monitoring unit may also provide the digital display  46  to display some or all of the cardiac information, respiratory information, etc. 
     The hub device  68  has a hub computing system  200  equipped with a processor  206 . The exemplary hub computing system  200  in the hub device  68  is equipped to communicate with the on-bed computing system  100  and the host network  76  via receiver/transmitters  209   a  and  209   b  respectively. The host network  76  comprises a wireless receiver/transmitter  77  to receive and transmit information to one or both of the hub device  68  and the on-bed computing system  100 . 
     The hub computing system  200  may further be configured to control the hub display  66 . In one embodiment, the on-bed computing system  100  and/or the hub computing system  200  may be configured to determine when the mobile newborn care bed  10  is in a predetermined position with respect to the radiant warmer  60 , such as attached to the radiant warmer  60  via the respective latching means  58  and  59 . For example, one of the mobile newborn care bed  10  and/or the radiant warmer  60  may be equipped with a proximity sensor to determine the distance between the bed  10  and warmer  60 . In one such embodiment, the mobile newborn care bed  10  and/or the radiant warmer  60  may be equipped with a proximity sensor device or other proximity determination capability to determine that the mobile newborn care bed  10  is within a predetermined distance of the radiant warmer  60 , such as in a position such that the warming element  62  is over the infant  2 . For example, such proximity sensors may be incorporated in or near the latching means  58  and  59  and/or in the base frame portion  52   a  of the mobile newborn care bed  10  or in the base frame portion  64   a  of the radiant warmer. In still other embodiments, the on-bed computing system  100  and/or the hub computing system  200  may include a distance determination module that estimates the position of the mobile newborn care bed  10  with respect to the radiant warmer  60  based on amplitude of wireless communication signals between the respective receiver/transmitters  109  and  209   a.    
     The on-bed computing system  100  and/or the hub computing system  200  on the hub device  68  may then control the hub display  66  to display the various monitoring information—e.g., cardiac information  82  and respiratory information  96 —being determined for the infant  2 . Additionally, when the hub display  66  is being operated, the digital display  46  on the mobile newborn care bed  10  may be turned off to conserve battery  48  charge. The on-bed computing system  100  and/or the hub computing system  200  may be configured to automatically provide such display operation. Likewise, one or more of the computing systems  100 ,  200  may be configured to automatically switch on the digital display  46  of the mobile newborn care bed  10  when the mobile newborn care bed  10  is de-latched or otherwise moved away from the radiant warmer  60 . Display commands from the on-bed computing system  100  may be routed to the hub display  66  through the hub computing system  200 . Alternatively or additionally, the on-bed computing system  100  may be configured to communicate wirelessly directly to the hub display  66 , which may have its own wireless receiver/transmitter. 
     Wireless communication between the on-bed computing system  100 , the hub device  68 , and the host network  76  may be by any wireless protocols known in the relevant art. In the depicted embodiment, the on-bed computing system  100  has receiver/transmitter  109  configured to communicate with receiver/transmitter  209   a  on the hub device  68 . The various receiver/transmitters  34 ,  35 ,  109 ,  209   a ,  209   b ,  77  may include separate receiving and transmitting devices or may include an integrated device providing both functions, such as a transceiver. The on-bed computing system  100  and hub device  68 , via respective receiver/transmitters  109  and  209   a , may be configured as medical body area network (MBAN) devices. In other embodiments, the receiver/transmitters  109  and  209   a  may communicate via other relatively short range radio protocols, such as Bluetooth, Bluetooth Low Energy (BLE), ANT, ZigBee, or NFC. In other embodiments, the communication may be via network protocols appropriate for longer-range wireless transmissions, such as on the wireless medical telemetry service (WMTS) spectrum or on a Wi-Fi-compliant wireless local area network (WLAN). In still other embodiments, the receiver/transmitters  109  and  209   a  may be capable of switching between two or more wireless communication protocols, such as to optimize data communication based on the situation. For example, the receiver/transmitters  109  and  209   a  may utilize a very short range protocol, such as an NFC protocol, if the mobile newborn care bed  10  is attached to the radiant warmer  60 , and may user a longer range communication protocol, such as Bluetooth or Wi-Fi, when the mobile newborn care bed  10  is not attached to or is more than a predetermined distance from the radiant warmer  60 . 
     Similarly, the hub device  68  may communicate with the host network  76  via receiver/transmitter  209   b  on the hub device  68  and receiver/transmitter  77  associated within or incorporated in the host network  76 , such as to transmit the cardiac information  82 , bradycardia event notification  83 , respiratory information  96 , weight  85 , or apnea event notification  86 . In other embodiments, the hub device  68  may be eliminated and the on-bed computing system  100  may communicate directly with the host network  76 . Such transmission may be via network protocol appropriate for longer-range wireless transmissions, such as on the WMTS spectrum or on a WLAN, as described above. 
     The host network  76  may be, for example, a local computer network having servers housed within a medical facility where the infant  2  is born, or it may be a cloud-based system housed by a cloud computing provider. The host network  76  may include a medical records database  78  housing the medical records for the infant  2 , which may be updated to store the information transmitted by the on-bed computing system  100  and/or the hub device  68 . The host network  76  may further include other patient care databases which may be accessed by or through either of the on-bed computing system  100  or the hub computing system  200 , such as an ECG database. 
       FIG. 3  provides a system diagram of an on-bed computing system  100  having cardiac module  70  executable to determine cardiac information  82 , resuscitation module  72  executable to determine respiratory information  96 , and load module  74  executable to determine a weight  85  for the infant  2  and/or detect an apnea event and generate a notification  86 . Furthermore, the cardiac module  70  may be executable to store the cardiac information  82  in storage system  104  of the on-bed computing system  100  so that such information may be accessed at a later time, such as to generate trend plots. Likewise, resuscitation module  72  may be executable to store respiratory information  96  and/or the measurement data from the sensors; and load module  74  may store the load measurements  84  and/or weight  85  and apnea event notifications  86  in storage system  104  of the on-bed computing system  100  so that such information may be accessed at a later time, such as to generate trend plots. For example, such information may be accessed by the various modules and/or by clinicians to determine whether the infant  2  is ready for discharge or whether certain physiological indicators indicate that continued care is needed, such as whether the infant  2  is experiencing continued apnea events and/or bradycardia events. 
     On-bed computing system  100  includes a processor  106 , storage system  104 , software  102 , and communication interface  108 . The processor  106  loads and executes software  102  from the storage system  104 , including the cardiac module  70 , resuscitation module  72 , and load module  74 , which are applications within the software  102 . Each of the modules  70 ,  72 ,  74  include computer-readable instructions that, when executed by the on-bed computing system  100  (including the processor  106 ), direct the processor  106  to operate as described herein. 
     Although the computing system  100  as depicted in  FIG. 3  includes one software  102  encapsulating one cardiac module  70 , one resuscitation module  72 , and one load module  74 , it should be understood that one or more software elements having one or more modules may provide the same operation. Similarly, while description as provided herein refers to a computing system  100  and a processor  106 , it is to be recognized that the methods and systems described herein be executed using one or more processors, which may be communicatively connected, and such implementations are considered to be within the scope of the description. 
     The processor  106  can comprise a microprocessor and other circuitry that retrieves and executes software  102  from storage system  104 . Processor  106  can be implemented within a single processing device but can also be distributed across multiple processing devices or sub-systems that cooperate in executing program instructions. Examples of processor  106  include general purpose central processing units, application specific processors, and logic devices, as well as any other type of processing device, combinations of processing devices, or variations thereof. 
     The storage system  104  can comprise any storage media, or group of storage media, readable by processor  106  and capable of storing software  102 . The storage system  104  may include volatile and non-volatile, removable and non-removable media implemented in any method or technology for storage of information, such as computer-readable instructions, data structures, program modules, or other data. Storage system  104  can be implemented as a single storage device but may also be implemented across multiple storage devices or sub-systems. Storage system  104  may further include additional elements, such a controller capable of communicating with the processor  106 . 
     Examples of storage media include random access memory, read only memory, magnetic discs, optical discs, flash memory, virtual memory, and non-virtual memory, magnetic sets, magnetic tape, magnetic disc storage or other magnetic storage devices, or any other medium which can be used to storage the desired information and that may be accessed by an instruction execution system, as well as any combination or variation thereof, or any other type of storage medium. Likewise, the storage media may be housed locally with the processor  106 , or may be distributed in one or more servers, which may be at multiple locations and networked, such as in cloud computing applications and systems. In some implementations, the storage media can be a non-transitory storage media. In some implementations, at least a portion of the storage media may be transitory. 
     The communication interface  108  is configured to provide communication between the processor  106  and various other systems and devices, including to receive measurement information from the various sensors and communicate commands and information to the hub device  68  and/or host network  76 . For example, communication interface  108  may control or include receiver/transmitter  35  that communicates with receiver/transmitter  34  on the respiration sensor device  26 . Likewise, communication interface  108  may control or include receiver/transmitter  109  that communicates with the receiver/transmitter  209   a  on the hub device  68 . Likewise, communication interface  108  may receive information from wired connections, such as from the pulse oximeter  22 , capacitive sensors  20 , load cell  15 , and/or ventilator device  40 . Likewise, communication interface  108  may communicate with the controller for the digital display  46 . 
       FIG. 4  depicts one embodiment of a method  120  of monitoring a newborn infant. The infant is received on the mobile newborn care bed  10  at step  121 , such as placed on the mattress  18  having incorporated capacitive sensors  20 . Cardiac potentials are recorded at step  122  via the capacitive sensors  20  to provide cardiac signals  81 . The recorded cardiac signals  81  are received at step  123 , such as at the on-bed computing system  100 . The heart rate is determined at step  124 , and the heart rate is displayed at step  125 . Step  126  determines whether the heart rate is less than a predetermined value, such as a value set by a clinician that is appropriate based on the infant&#39;s age and size. If the heart rate is not less than the predetermined value then a bradycardia event is not detected and the heart rate is transmitted at step  129   a  such as to the hub device  68  or the host network  76 . If the heart rate is less than the predetermined value then a bradycardia event is detected and a bradycardia event notification is generated at step  127 . An alert may be displayed at step  128 , such as on the digital display  46  on the mobile newborn care bed  10  and/or the hub display  66 . The heart rate and bradycardia event notification are then transmitted at step  129   b . In one embodiment, steps  123  through  129  are carried out by executing software of the cardiac module  70  on the processor  106  of the on-bed computing system  100 . Furthermore, the cardiac module  70  may execute steps to determine other cardiac information  82  based on the cardiac signals  81 , such as morphology-related values or trending assessments. 
       FIG. 5  depicts another embodiment of a method  120  of monitoring a newborn infant. When the infant is received on the mobile newborn care bed  10  at step  121 , the load is measured at step  132  via one or more load cells  15 . The load measurement is received at step  133 , such as at the on-bed computing system  100 . A weight  85  is determined at step  134  based on the load measurement  84 . At step  135  it is determined whether breathing oscillations in the load measurement  84  are detected. Changes in distribution of load on the one or more load cells  15  will be caused by the up and down movements of the infant&#39;s diaphragm while the infant breaths. If such load distribution changes or oscillations in the load measurement  84  are detected, then it is determined that the infant  2  is breathing. For example, oscillations of a particular frequency, or threshold frequency, may be required at step  135 . If the requisite oscillations are detected, then it is determined that an apnea event is not occurring and the weight  85  value can be transmitted at step  138   a , such as to the hub device  68  or the host network  76 . If the requirements of step  135  are not satisfied, then an apnea event is detected and an apnea event notification is generated at step  136 . An alert may be displayed on the digital display  46  and/or the hub display  66  at step  137 , and the weight and apnea event notification are transmitted at step  138   b . In one embodiment, steps  133  through  138  may be carried out by executing instructions of the load module  74  on processor  106  of the on-bed computing system  100 . 
       FIG. 6  depicts one embodiment of a method  140  of providing resuscitative care to an infant  2 . A respiration sensor device  26  is provided at step  141 , and the respiration sensor device  26  is placed in the breathing circuit  25  at step  142 , such as between the mask  36  and breathing tube  38 . The breathing circuit  25  is provided to the infant  2  at step  143 , such as by placing the mask over the infant&#39;s nose and mouth. One or more respiration parameters are measured by various sensors within the breathing circuit  25 , such as O 2 , CO 2 , flow rate, pressure, volume, and temperature. O 2  measurements are received at step  144 , such as by a respiratory module  72  in the software of the on-bed computing system  100 . The respiratory module  72  then determines an FiO 2  value at step  145  based on the O 2  measurements. Similarly CO 2  measurements are received at step  146  and an etCO 2  value is determined at step  147  based on the CO 2  measurements. Flow measurements are received at step  148  and a title volume is determined at step  149  based on the flow measurements. For example, a person having ordinary skill in the art will understand in light of this disclosure that the tidal volume may be calculated as an area under the flow curve formed by flow measurements recorded over a breath cycle of the infant  2 . Pressure measurements are received at step  150 , and a ventilation pressure is determined at step  151 . Temperature measurements are received at step  152  and a temperature is determined at step  153  for the infant  2 . Some or all of the forgoing respiratory information may be displayed at step  154 , such as on the digital display  46  and/or the hub display  66 . The respiratory information is transmitted at step  155 , such as to the hub device  68  and/or the host network  76  as described herein. In one embodiment, steps  144  through  155  are carried out by executing instructions of the resuscitation module  72  on processor  106  of the on-bed computing system  100 , or on a processor of the ventilator device  40 . In another embodiment, one or more of the steps  144 - 153  are carried out within the respiration sensor device  26 , such as by executing corresponding software instructions on the processor  33  thereof. The respective values generated at those steps may be transmitted to the on-bed computing system  100 , which may then execute steps  154  and  155 . 
     This written description uses examples to disclose the invention, including the best mode, and also to enable any person skilled in the art to make and use the invention. Certain terms have been used for brevity, clarity and understanding. No unnecessary limitations are to be inferred therefrom beyond the requirement of the prior art because such terms are used for descriptive purposes only and are intended to be broadly construed. The patentable scope of the invention is defined by the claims, and may include other examples that occur to those skilled in the art. Such other examples are intended to be within the scope of the claims if they have features or structural elements that do not differ from the literal language of the claims, or if they include equivalent features or structural elements with insubstantial differences from the literal languages of the claims.