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How To Choose The Right Doppler

 

As a major supplier of medical Dopplers for over 30 years, we often get questions from customers about the difference in Dopplers and brands that we carry. Some of the most common questions include: Which type of Doppler is the best? What brand is the most trusted? What probe would be best for my practice?

With so many different options available to you, the easiest thing to remember is that there is no 'ideal' Doppler. Choosing the right Doppler is really based on understanding what you will be using it for and what features are most important to you as a practitioner.

To help you out, here are the top 5 questions we ask customers when they are looking for a new Doppler.

  1. What brand of Doppler have you used this far?
    Each brand is different, whether in size, shape or probe shape. If you are accustomed to, and enjoy the handling of a specific brand's design, we often suggest choosing the same brand.

  2. If purchasing an obstetric Doppler, how important is early detection for your practice?
    This helps when choosing your probe. 2 MHz probes are for general use and commonly detect Fetal Heart Rates (FHR) around 10 weeks; whereas 3 MHz probes are more enhanced, offering early detection of FHR around 8 weeks.

  3. Do you require a waterproof probe? If so, how frequently?
    This helps for brand choice. Huntleigh waterproof probes are fixed to the Doppler so you can't change the probe. Nicolet Elite, Summit LifeDop and Newman DigiDop Dopplers are all multi-use units, which means their probes are interchangeable, allowing you to use the same unit with different probes when desired.

  4. Do you need a Doppler that can be used for obstetrical and vascular purposes? If so, which will you use it for the most?
    Huntleigh offers dual-use handheld Dopplers and all the other brands we carry are multi-purpose handheld Dopplers for both obstetrical and vascular use. However, when using the same Doppler for both purposes, regardless of brand, you will lose specific features depending on the unit you choose. Digital display units designed for showing FHR will not function when used for vascular purposes and audio-only units designed for vascular readings will not show FHR when used for obstetrical purposes. Always choose a Doppler designed for the predominant application, and if you regularly perform both obstetrical and vascular examinations, get an obstetric and a vascular Doppler for best results.

  5. Are you going to want to use different probes regularly?
    If the answer to this question is yes, it is more economical to choose a Doppler that allows you to change the probes. You will save money by only needing to buy one Doppler that you can purchase different probes for, allowing you the flexibility to simply attach a different probe to suit the situation. We sell obstetrical and vascular probes separately for all the brands we carry.

Now that you've answered those five simple questions, here is a general breakdown of the key features each brand offers.

HUNTLEIGH DOPPLERS

         

Huntleigh was the first brand to introduce waterproof Dopplers, and have since been the most well-known brand for waterproof units.

  • The waterproof probe is sealed where it attaches to the Doppler - meaning it is not interchangeable. This feature makes it shock resistant and protects the unit from accidental fluid spills.
  • Huntleigh obstetric Dopplers are known for the quickness of their response to changing heart tones.
  • All Huntleigh Dopplers have built-in shock resistance that helps protect them against bumps or jostling.
  • Digital display and audio-only options are available, depending on your preference.
  • Huntleigh offers 8 MHz sterilizable vascular probes for use with their Intraoperative Dopplers.

NICOLET ELITE AND NICOLET IMEX DOPPLERS

      

Nicolet Elite and Nicolet Imex handheld Dopplers are multi-use and are among the most economical portable Doppler units we offer.

  • Nicolet Doppler probes are known for a shorter, wider, round shape, which some find preferable.
  • Elite offers a 2 MHz waterproof probe for use with all handheld Elite Dopplers.
  • Imex offers a 2 MHz waterproof probe for use with the Imex Pocket-Dop II and Imex CT+ Doppler.
  • All Nicolet Elite and Imex Dopplers are multi-use. Elite probes are interchangeable with any Elite Doppler and Imex probes are interchangeable with any Imex Doppler, allowing you the flexibility to use multiple probes without the cost of having to buy multiple Dopplers.
  • Digital display and audio-only Dopplers are available depending on your preference.

SUMMIT LIFEDOP DOPPLERS

  

Summit LifeDop handheld Dopplers are multi-use units as well. What makes the LifeDop Doppler stand out is the convenience and portable design of their vascular ABI handheld Dopplers with portable printers.

  • All handheld LifeDop Dopplers are multi-use units, allowing you the ability to use a variety of probes with the same Doppler.
  • Summit offers a 5 MHz transvaginal probe for early fetal heartbeat detection. This probe is specially designed for use on women who are obese or have a retroverted uterus.
  • Summit offers a 2 MHz waterproof probe.
  • Summit offers 8 MHz sterilizable LifeDop vascular probes.
  • LifeDop probes are all interchangeable and can be used with any LifeDop Doppler, except the ABI System Dopplers. LifeDop ABI Dopplers can only use LifeDop ABI vascular probes.
  • The LifeDop ABI Systems with portable printers are one of the best ABI systems with printers available and the most portable option we offer.
  • Digital display and audio-only options are available, depending on your preference.

As far as probes are concerned, here is a quick reference guide for the general uses of each type of probe. To see the selection of probes available for each brand, just click the brand name: Huntleigh probes, Nicolet Elite probes, Nicolet Imex probes, Newman DigiDop probes, Summit LifeDop probes.

Obstetric Probes

  • 2 MHz probe: detects Fetal Heart Rate (FHR) as early as 10 weeks for most Dopplers.
  • 3 MHz probe: enhanced to detect FHR as early as 8 weeks for most Dopplers.
  • 2 MHz waterproof probe: same function as the regular 2 MHz probe, only it is waterproof and commonly used for water births.
  • 3 MHz waterproof probe (offered by Newman DigiDop): same function as the regular 3 MHz probe, only it is waterproof and commonly used for water births.
  • 5 MHz transvaginal probe (offered by Summit LifeDop): for early detection of FHR in women who are obese or have a retroverted uterus.

Vascular Probes

  • 4 MHz probe (offered by Huntleigh and Summit LifeDop): for detection of deep lying vessels.
  • 5 MHz probe: commonly used for vascular testing above the knee and above the elbow. Ideal for detection of deep lying vessels.
  • 8 MHz probe: most common general use vascular probe, commonly used for vascular testing below the knee and below the elbow. Ideal for detection of peripheral vessels.
  • 8 MHz sterilizable probe (offered by Huntleigh and Summit LifeDop): offers all of the same functions as the regular 8 MHz probe but is sterilizable.
  • 10 MHz probe (offered by Huntleigh): for detection of smaller vessels in specialist superficial applications. Commonly used by plastic surgeons for checking blood flow for skin grafts.

At Cascade HealthCare, we have carefully selected each brand of Doppler we carry for three common reasons. First, all of the brands offer high quality Dopplers - none of which are made in China. Secondly, each brand we carry is known for designing durable, reliable Dopplers that will serve you for years. Thirdly, we only choose companies that stand behind their products, that have excellent customer service departments, and that offer good warranties for their products. Good customer relationships are part of the foundation that makes up Cascade HealthCare Products, which is why we only work with companies that provide you with the same high level of service and quality we expect and offer.

Hopefully the above information will be useful during your next Doppler purchase, but as always, if you have any lingering questions, let us know! You can find our email and telephone number in our Contact Us section by clicking here.

If you enjoyed this post, the topics covered in the following blog posts may also be of interest to you: 'How to Choose Sutures', 'Entering the New Age of Midwifery', and 'Making Urine Test Strips Last Longer'. Click the post title to view the full article, or scroll through our complete archive of posts by clicking here.

Written By: Samantha Darling for Cascade HealthCare Products

What to Consider When Buying Your Home Birth Kit

One of the greatest resources available to midwives is the opportunity for them to create specialized birth kits that include everything an expectant mother will need when the big day arrives. Since each midwife is unique, so is her birth kit, and choosing where to purchase your birth kit takes a little extra thought to make sure it arrives as you want it, when you want it.

Here are the top 5 factors to consider when choosing where to purchase your specialized midwife kit or fully-equipped general home birth kit.

1. Quality

When midwives design their birth kits, they develop a list of items they want included. From there, each company that carries their birth kit has the freedom to choose the brand and quality of each listed item. Choosing the cheapest birth kit isn't always the best route if you want quality items.

For instance, you definitely want your birth kit to have a high quality underpad. Low quality underpads have poor absorbancy and leave you with the risk of leakage if there is a lot of liquid during the birth. Be sure to identify these features before you choose a kit, and if the details aren't listed don't be afraid to ask.

2. Shipping Time

When you're pregnant it can seem like the to-do list is never ending and sometimes ordering your birth kit seems to slip through the cracks! Be sure to identify how long a company takes to ship your order and when it will be shipped by.

If you are ordering your birth kit close to your due date, it is important to make sure you know the estimated date of delivery, since a lot of companies do not accept birth kit returns for sanitary reasons. If you are really nervous, expedited shipping is an option but it will cost more. Better yet, choose a company that offers prompt shipping. Birth Kits don't take long to assemble and at Cascade we have them sent out within 24 hours of you ordering them.

We recommend that you order your kit approximately 6 weeks prior to your due date to ensure that no matter when your baby arrives, you are prepared and ready!

3. Accuracy

 There is nothing worse than having your due date approaching only to find your birth kit has been assembled incorrectly! Dealing with the hassle of having the problem corrected or even paying extra to just purchase an item that was forgotten, is an unnecessary waste of time and energy.

If you are choosing a birth kit from a company you haven't purchased from before, ask your midwife, doula or another mother what their experiences as a customer were like with the company. Also, don't be afraid to call the company and ask how they check their orders before shipping them.

At Cascade, we have a thorough 3 step process: one person assembles your  order; another does an accuracy check for correct numbers, colors and products (with a checklist!); and finally once everything is boxed, we have someone check that the order corresponds with the address and order number. When you've been assembling birth kits for over 30 years, finding an efficient checking process is inevitable!

4. Be an Efficient Shopper

Most companies that carry birth kits will also carry a variety of items you will need once your baby arrives. From breastfeeding products like nursing pads and natural creams for soothing and protecting nipples, to newborn basic blankets and clothing, take a moment to think ahead for items you will need after birth.

 

Why? Two good reasons:

  • Depending on what you're buying, you're probably going to save money on shipping. Most postal options in the US are based on the size of the box being shipped, not the weight. So the more you can fit into the box, the better!

  • Time. When you have a new baby, looking through products, reading ingredients, doing price comparisons, all feel like luxuries. Even if you get prepared with the basics for breastfeeding or perineal care (i.e. the cold pads that help reduce perineal swelling after birth), that will save you precious time better spent with your baby than in a store or online.

 

 

5. Talk to a Person, Not an Automated System

One of the most precious aspects of choosing a midwife and the option to give birth at home or at a birth center, is the personal, intimate touch every step of the way. The right company will offer you the same personal care. Being a part of the midwifery community means more than selling a product, it is a unique opportunity to be a part of a support system that values the importance of individuals and not just sales.

 

So choose a company that connects you to a knowledgeable person who can answer your questions and guide you if you need assistance. Because the more you know, the better prepared you will be!

At Cascade HealthCare it is our guarantee that the birth kit you purchase is comprised of quality items that are packaged with careful attention and shipped within 24 hours of being ordered. Our goal is to be a helping hand and invaluable resource whenever you have questions, so don't hesitate to call or email us! You can find our email and telephone number in our Contact Us section by clicking here.

If you enjoyed this post, the topics covered in the following blog posts may also be of interest to you: 'Why Water Birth?', 'Why Do We Use Fetoscopes?', and 'Why Do We Use Plastic Cord Clamps?'. Click the post title to view the full article, or scroll through our complete archive of posts by clicking here.

Written By: Samantha Darling for Cascade HealthCare Products

Why Water Birth?

Water births are not just an option for home or birth center deliveries, there are hospitals that also offer women the option of a water birth with a trained midwife. With each pregnancy being unique, the first step in deciding whether to have a water birth and where to have it, is to consult with your midwife. A midwife will be an invaluable resource for helping you choose the best birthing option for your labor, while offering insight into the best birth and delivery options available to you.

Why choose a water birth?

The general theory behind water birth is that being born into warm water is a gentler transition for babies who have been in the amniotic fluid sac for 9 months. Water birth pools also offer a soothing, warm environment for laboring women. Delivering in water is not the sole purpose of a water birth pool, it can also be a therapeutic space that women use during labor with the option to get out for their delivery if they choose to.

Be Informed

Being informed is the most vital part of any birthing process, and understanding the pros and cons of a water birth will help parents decide what the best route is for them. So here are some great points noted by the American Pregnancy Association on the Benefits and Potential Risks of Water Birth:

Benefits to Mothers1

  • The effect of buoyancy lessens a mother’s body weight, allowing free movement and new positioning.
  • Buoyancy promotes more efficient uterine contractions and improved blood circulation resulting in better oxygenation of the uterine muscles, less pain for the mother, and more oxygen for the baby.
  • Water causes the perineum to become more elastic and relaxed, reducing the incidence and severity of tearing and the need for an episiotomy and stitches.
  • Since the water provides a greater sense of privacy, it can reduce inhibitions, anxiety, and fears.

When Water Birth is Not Ideal2

  • If you have Herpes: Herpes transfers easily in water. Discuss this risk thoroughly with your healthcare provider.
  • If your baby is breech: Though water birth has been done with bottom or feet first presentations you should discuss this risk thoroughly with your healthcare provider.
  • If you have been diagnosed with one of the following: excessive bleeding or maternal infection.
  • If preterm labor is expected: If a baby is pre-term (two weeks or more prior to due date), water birth is not recommended.
  • If you have toxemia or preeclampsia: You should thoroughly discuss this risk with your healthcare provider.
  • If you are having multiples: Though water births have been successful around the world with twin birth, you should discuss this risk thoroughly with your healthcare provider.

Choosing a Water Birth Pool

With a variety of water birth tubs available for sale and even the option to rent them, choosing the right birth pool basically comes down to understanding what features will make you most comfortable. From Birth Pool in a Box to La Bassine, each option has unique features to suit your needs.

Tips for Easy Set-Up, Use and Clean-Up

  • Test your birth pool by inflating it before your due date to make sure no air is leaking.
  • Use a liner to ensure good sanitation. Plus, liners make it easy to clean up, eliminating the need to dry the tub.
  • Make sure you have all the necessary supplies to fill up your pool - air pump, drain pump, hose.
  • Choose a tub with handles comfortable for you.
  • Use a cover to keep the water's warmth in once filled and for times when you aren't in the tub.
  • Choose a tub with a built-in seat or use a stool for comfort during labor and for ease while holding your new baby without sumberging her/his head in water.

At Cascade HealthCare Products we offer Birth Pool in a Box in both mini sizes, ideal for tight spaces and full sizes that can fit birth partners and midwives inside too. Why we exclusively carry Birth Pool in a Box is easy:

  • It's the only tub designed with a built-in seat for comfort during labor & bonding with your baby after birth.
  • The handles are placed on the outside, out of the baby's way and ideal for a good, sturdy grasp.
  • It is adjustable and can be adjusted to the right height for you.
  • They are reusable and easy to clean when you use a disposable liner, eliminating the need to dry the pool.
  • 100% backed by the manufacturer for quality. We have never had a complaint about the quality of these tubs in the 6+ years we've carried them!

To see our selection of water birth pools by Birth Pool in a Box, just click here!

If you enjoyed this post, the topics covered in the following blog posts may also be of interest to you: 'What to Consider When Buying Your Home Birth Kit', 'Entering the New Age of Midwifery', and 'Why Do We Use Plastic Cord Clamps?'. Click the post title to view the full article, or scroll through our complete archive of posts by clicking here.

Written By: Samantha Darling for Cascade HealthCare Products

 

 

Resources

1,2American Pregnancy Association, Water Birth

Waterbirth International

OHSU Center for Women's Health, Benefits of Waterbirth

The American Congress of Obstetricians and Gynecologists, Immersion in Water During Labor and Delivery

The Importance of Newborn Pulse Oximeters

 

Why are pulse oximeters important for birthing professionals to have? When a new baby is born, it has become standard procedure to check for a handful of very specific medical conditions, one of which is critical congenital heart defect (CCHD). According to the Center for Disease Control and Prevention (CDC): "About 1 in every 4 babies born with a heart defect has a critical congenital heart defect (critical CHD, also known as critical congenital heart disease)"1. If not diagnosed soon after birth, "babies with a critical congenital heart defect (CCHD) are at significant risk of disability or death if their condition is not diagnosed soon after birth."2 Enter...the pulse oximeter.

Pulse oximetry is a procedure that uses a non-invasive unit - a pulse oximeter - to measure blood oxygen saturation. In certain instances, a pulse oximeter can identify infants with CCHD before they actually exhibit signs of the condition3. But getting a newborn's reading is not as easy as one might think. With their small, flexible fingers and toes, using a traditional pulse oximeter with a finger probe is not only difficult, it's inefficient. The best option is to use a motion sensitive pulse oximeter with a sensor that can be wrapped around the baby's foot or hand.

MOTION SENSITIVE MASIMO RAD-5 PULSE OXIMETER

The Masimo Rad-5 Pulse Oximeter System is one of the best pulse oximeters on the market for newborn readings because of its unique motion sensitive design. At Cascade HealthCare Products, we started carrying the Rad-5 at the request of our midwives who found it too difficult to get an accurate reading with a regular pulse oximeter. The Rad-5 is specially designed to be motion tolerant for newborns and offers a range of sizes for sensor wraps that fit neonates, infants, children and adults. This system has also been scientifically and clinically proven to offer accurate measurements during motion and low perfusion4.

The Masimo Rad-5 Pulse Oximeter also comes with a reusable sensor, which is far more cost effective than disposable sensors because all you need to purchase are the wraps. Our test group of midwives in Wisconsin even discovered that they could craft their own wraps from cloth, which they found to be equally as effective with the reusable sensors. The Rad-5 is also handy for situations where protocol calls for one-time-use sensors. Simply remove the reusable sensor and insert the sterile disposable sensor for fast and easy readings.

EASY AS 1, 2, 3

Here is a simple guide for how the Rad-5 Pulse Oximeter works, for hands on the left and feet on the right.

 

If you enjoyed this post, the topics covered in the following blog posts may also be of interest to you: 'Why Do We Use Fetoscopes?', 'How to Choose the Right Doppler', and 'Entering the New Age of Midwifery'. Click the post title to view the full article, or scroll through our complete archive of posts by clicking here.

Written By: Samantha Darling for Cascade HealthCare Products

 

Resources

1Center for Disease Control and Prevention, Congenital Heart Defects (CHDs): http://www.cdc.gov/ncbddd/heartdefects/cchd-facts.html

2,3Center for Disease Control and Prevention, Newborn Screening: http://www.cdc.gov/ncbddd/newbornscreening/

4Pulse Oximeters, Cascade HealthCare Products Inc.

A Glimpse at the Incredible Life of Patsy Harman

At Cascade HealthCare Products we are often in awe of the incredible midwives we work with. These are women who have not only played an integral role in the lives of hundreds of families, but who have often led exceptionally interesting lives of their own. One such woman is Patsy Harman - midwife, mother, author, wife, childbirth educator and life explorer. Sit back and join us as we journey through the intriguing life moments that led extraordinary women like Patsy into the passionate world of midwifery.

 

How did you get started as a midwife? 

I began my life as a midwife and childbirth educator in 1972, in Duluth Minnesota. At that time there were no Lamaze classes or any way to have a father at the birth. My partner and I took the Greyhound bus to Minneapolis for 6 weeks to learn how to breathe! After that, we found a small hospital about thirty miles away that would let us be together. Twenty-four hours of back labor and a forceps delivery of my first boy made me want to help other women. It wasn’t an awful birth, it was just hard. That’s why they call it hard labor, right? Nowadays, I would have had a C/S, no question.

A few years later, I began attending hospital births as a labor coach and began to read everything I could about natural birth. I read Varney’s Midwifery, Spiritual Midwifery, Childbirth Without Fear, Bradley [author of Husband-Coached Childbirth] ... everything from cover to cover. 

In the late seventies we moved to a rural commune in West Virginia where childbirth was even more behind the times. I started teaching childbirth classes to the other hippie homesteaders and soon found myself delivering babies. At one point I hitchhiked with another woman to Texas and did a two month rotation with the home birth midwives in Austin. Sometimes, it feels like I’m making this up! I didn’t plan to be a midwife, but I was called.

*For more on these incredible stories, read Harman's second book, Arms Wide Open: A Midwife's Journey1.

What were the barriers you had to face as a midwife?

I didn’t find many barriers, I just went out and started delivering babies. At that time we were young, strong, fearless and healthy. We didn’t know anything about 'living off the land', but we got books and we learned. It was the same way with delivering babies - get a book, deliver a baby. It all seemed straight forward and natural, but keep in mind the women I was helping were all in their twenties - lean, strong, had no risk factors, could drag a log out of the woods and carry two 5 gallon buckets of water a 1/4 mile and weren’t afraid of pain. In 100 deliveries we had one C-section.

As a CNM I also didn’t have many barriers, because my hippie, bee-keeper-string bass player became an OB-Gyn and we practiced together.

You were doing so well as a self-taught home birth midwife, why did you go back to school to become a CNM? 

I had a part time job, through the War on Poverty, to visit the poorest of the poor in West Virginia. With 3 years of college experience, I would go to homes of women who had been identified as eager to help their families, and I would teach them skills in sewing and nutrition. We would get to talking about childbirth and I realized I wanted to help them in that area too, but they were too high risk and needed to be in a hospital setting. So began my journey of going back to school to get certified. That was the only reason. I knew I needed to get credentials so I could work in a medical setting that helped the poor as well as the hippie elite.

Where did you get support? 

I got support from my husband, my commune and the families that I had helped. I also got support from the WV Coalition of Home Birth Midwives that we founded. We would meet every few months to share stories, thoughts and feelings. I miss those meetings. The midwifery meetings I go to now are more research-political.

How long did it take to get through your training? 

I started as an LPN, because the War on Poverty was giving out grants to go back to school. Then I got a two year RN. I worked in a low-tech hospital labor and delivery in Ohio, while I got B.S. in Health Care Administration on-line. I never thought of being an administrator, I just needed some kind of 4 year degree to get into a nurse-midwifery school. A year later I got into the University of Minnesota graduate program which took two years to finish. So all told it took about five years. Keep in mind, I also had 3 little boys and a husband who was going back to school too.

What was the most memorable moment you had as a midwife? 

Too many to remember!  Maybe the first baby I delivered in a commune by candlelight (see Arms Wide Open: A Midwife's Journey for more on this story). I was only supposed to be the coach, but I ended up delivering the baby during a snow storm and that's where I found my true calling.

What are you passionate about besides delivering babies? 

Saving Mother Earth. Everyone in the world having enough clean water and food. Everyone having warmth and love.  Everyone!

What motivated you to start writing?

My husband, Tom, became in OB/Gyn in 1987 and we delivered babies as partners in the hospital and the birthing rooms for 20 years. Then about 10 years ago, there was a big medical liability insurance crisis, our premium doubled to $140,000 a year and we had to stop doing OB. It was a great loss to our patients, our city and to us, but it gave me more time and energy to reflect on the human condition and the state of childbirth. I began to listen more to women’s stories and I wanted to share them, so I wrote my first book, The Blue Cotton Gown2. It is a memoir about the courage of ordinary women.

What is it like to be an author?

It is great fun to write, especially fiction, like my first novel, The Midwife of Hope River3 and the sequel, The Reluctant Midwife4. A surprise benefit is that I go to book clubs, book festivals and book stores where I talk to people about midwifery and the state of childbirth in the United States. I feel I’ve become a spokesperson and that’s vey gratifying. I was honored that The Midwife of Hope River was chosen as The Book of the Year in 2014 by The American College of Nurse Midwives and it was also a USA Today best seller. Not to mention, it has also been translated into eight languages!

Have you faced any difficulties writing about midwifery?

The trickiest part is protecting each patient’s privacy. In my non-fiction books I had to deeply disguise everyone and most of the time, I also let them read the chapters they were in  so they could give their consent. I also try not to make anything too gross when I write about childbirth or illness or death. Not everyone is as comfortable with body parts and secretions as midwives, doulas, lactation guides and doctors. 

Can you describe the essence of your books in one sentence?  

My books are about the power of childbirth, family and community, as well as healing, hope, love and courage.

 

***

Written By: Samantha Darling for Cascade HealthCare Products

 

References

1Beacon Press
2Beacon Press
3William Morrow and Company
4William Morrow and Company