Scribd Logo
Upload

Welcome to Scribd!

  • 338 views

    Hypothermia

    Uploaded by

    MRS CHAKRAPANI
    Hypothermia is a serious risk for newborns and can lead to death. To prevent hypothermia, a "warm chain" of 10 procedures must be followed, including keeping the baby warm and dry, delaying baths, and skin-to-skin contact. Newborns are susceptible to heat loss through evaporation, conduction, convection, and radiation. Hypothermia is graded based on temperature and treated by rewarming methods like skin-to-skin contact or an incubator depending on severity. Kangaroo mother care is effective for warming low birth weight babies.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd

    Hypothermia

    Uploaded by

    MRS CHAKRAPANI
    338 views5 pages
    Hypothermia is a serious risk for newborns and can lead to death. To prevent hypothermia, a "warm chain" of 10 procedures must be followed, including keeping the baby warm and dry, delaying baths, and skin-to-skin contact. Newborns are susceptible to heat loss through evaporation, conduction, convection, and radiation. Hypothermia is graded based on temperature and treated by rewarming methods like skin-to-skin contact or an incubator depending on severity. Kangaroo mother care is effective for warming low birth weight babies.

    Original Description:

    management of hypothermia

    Copyright

    © © All Rights Reserved

    Available Formats

    PDF, TXT or read online from Scribd

    Did you find this document useful?

    Is this content inappropriate?

    Hypothermia is a serious risk for newborns and can lead to death. To prevent hypothermia, a "warm chain" of 10 procedures must be followed, including keeping the baby warm and dry, delaying baths, and skin-to-skin contact. Newborns are susceptible to heat loss through evaporation, conduction, convection, and radiation. Hypothermia is graded based on temperature and treated by rewarming methods like skin-to-skin contact or an incubator depending on severity. Kangaroo mother care is effective for warming low birth weight babies.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    338 views5 pages

    Hypothermia

    Uploaded by

    MRS CHAKRAPANI
    Hypothermia is a serious risk for newborns and can lead to death. To prevent hypothermia, a "warm chain" of 10 procedures must be followed, including keeping the baby warm and dry, delaying baths, and skin-to-skin contact. Newborns are susceptible to heat loss through evaporation, conduction, convection, and radiation. Hypothermia is graded based on temperature and treated by rewarming methods like skin-to-skin contact or an incubator depending on severity. Kangaroo mother care is effective for warming low birth weight babies.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    You are on page 1of 5

    Chapter 2

    HYPOTHERMIA AND THERMAL CONTROL


    Provision of warmth to prevent hypothermia is one of the cardinal principles of newborn
    care. Hypothermia can lead to hypoglycemia, bleeding diathesis, pulmonary hemorrhage,
    acidosis, apnea, respiratory failure, shock and even death. Neonatal hypothermia
    continues to be a very important cause of neonatal deaths due to lack of attention by
    health care providers.
    Learning Objectives:
    After completion of this module the participant should be able to

    Enumerate the mechanism of heat loss


    Understand the concept of warm chain
    Grade hypothermia
    Prevent & manage hypothermia

    Mechanisms of heat loss


    Newborn loses heat by evaporation (particularly soon after birth due to evaporation of
    amniotic fluid from skin surface), conduction (by coming in contact with cold objectscloth, tray, etc.), convection (by air currents in which cold air replaces warm air around
    baby-open window, fans) and radiation (to colder solid objects in vicinity-walls) (Fig
    2.1). The process of heat gain is by conduction, convection and radiation in addition to
    non-shivering thermogenesis.
    Warm chain
    Baby must be kept warm at all times right from birth. Satisfactory control of temperature
    demands both prevention of heat loss and promotion of heat gain. The warm chain is a
    set of ten interlinked procedures carried out at birth and later, which will minimize the
    likelihood of hypothermia in all newborns.
    1. Warm delivery room (>25 oC)
    2. Warm resuscitation
    3. Immediate drying
    4. Skin-to-skin contact between baby and the mother
    5. Breastfeeding
    6. Bathing and weighing postponed
    7. Appropriate clothing and bedding
    8. Mother and baby together
    9. Warm transportation
    10. Training/awareness-raising of healthcare provider

    NATIONAL NEONATOLOGY FORUM

    Fig 2.1 : Mechanism of heat loss in a newborn


    ASSESSMENT OF TEMPERATURE & GRADING OF HYPOTHERMIA
    Normal axillary temperature
    Cold stress
    Moderate hypothermia
    Severe hypothermia

    : 36.5-37.5 0 C
    : 36.4 to 36.0 0 C
    : 35.9 to 32 0 C
    : < 32 0 C

    Temperature recording
    (a) Axillary temperature is as good as rectal and probably safer (less risk of injury or
    infection). It is recorded by placing the bulb of thermometer against the roof of
    dry axilla, free from moisture. Babys arm is held close to the body to keep
    thermometer in place. The temperature is read after five minutes.
    (b) Rectal temperature: Do not use this method for routine monitoring. However, it is
    the best guide for core temperature in cold (hypothermic) sick neonates. It is
    recorded by inserting the greased bulb of the thermometer backwards and
    downwards to a depth of 3 cm in a term baby (2 cm in a preterm baby). Keep
    thermometer in place at least for 2 minutes. Rectal temperature is not recorded as
    a standard procedure in neonate. Record rectal temperature only for a sick,
    hypothermic newborn.
    (c) Skin temperature: Skin temperature is recorded by a thermister. The probe of the
    thermister is attached to the skin over upper abdomen. The thermister senses the
    skin temperature and displays it on the panel.
    (d) Human touch: Babys temperature can be assessed with reasonable precision by
    human touch the reliability of which can be enhanced by training. Abdominal
    temperature is representative of the core temperature and it is reliable in the
    diagnosis of hypothermia.
    The warm and pink feet of the baby indicate that the baby is in thermal comfort. But
    when feet are cold and abdomen is warm, it indicates that the baby is in cold stress. In
    hypothermia, both feet and abdomen are cold to touch.

    NATIONAL NEONATOLOGY FORUM

    Prevention & Management of hypothermia


    Prevention of hypothermia
    1. In the delivery room
    Conduct delivery in a warm room.
    Immediately dry newborn with a clean soft preferably warm towel
    Use another warm towel to wrap the baby in two layers
    Ensure head is well covered
    Keep the baby by the side of the mother (mothers temperature will keep
    the baby warm
    2. Skin-to-skin contact (Kangaroo mother care - KMC)
    (a) Assists in maintaining temperature of infant
    (b) Facilitates breastfeeding
    (c) Helps to increase duration of breastfeeding and
    (d) Improves mother infant bonding
    A baby who is born LBW (less than 2500 g) often needs special care in a hospital.
    Mother can provide warmth by doing KMC to the baby at home or even in the hospital, if
    there are no signs of distress or extreme prematurity.
    Place the baby naked, with a nappy, upright inside mothers clothing
    against skin. (A loose blouse, sweater or wrap tied at the waist holds the
    baby)
    Let baby suckle at breasts as often as he wants, but at least every 2 hourly
    Sleep propped up so that the baby stays upright
    Make sure the baby stays warm at all times. If environment is cool, dress
    the baby with extra clothing and cover his head.
    When mother wants to bathe or rest, ask the father or another family
    member to do KMC for the baby or wrap infant in several layers of warm
    clothing, covered with blankets and keep in a warm place
    Management of hypothermia
    At Health Centre/FRU/Hospital, confirm diagnosis of hypothermia by recording actual
    body temperature. A hypothermic baby has to be rewarmed as quickly as possible. The
    method selected will depends on the severity of hypothermia and availability of staff and
    equipment.
    The methods to use include.
    Skin-to-skin contact
    A warm room or bed
    A radiant heater or an incubator
    Infection should be suspected, if despite taking above measures hypothermia still persists.

    NATIONAL NEONATOLOGY FORUM

    Hypothermia (Temp <36oC)


    Use manually operated radiant warmer set at 37-38 0C or air heated incubator (air temp
    35-36 0C). Once babys temperature reaches 34 0C the re-warming process should be
    slowed down. Continue re-warming till temperature reaches normal range. Monitor every
    15-30 minutes. Alternately, one may use room heater or other means to warm the baby.
    Skin-to-skin contact should be in a warm room and warm bed. Monitor B.P., HR,
    temperature and glucose (if facilities are available).
    In addition

    Take measures to reduce heat loss


    Start IV 10% Dextrose
    Give Inj Vit K 1 mg I/M to term neonates & 0.5 mg I/M to preterm
    Provide oxygen

    Fever
    Fever (temperature above 37.5 0C) is a sign of infection usually in a term neonate. In all
    febrile neonates, a diligent search for a possible infective focus must be made. In summer
    months, hyperthermia may occur due to raised environmental temperature. This may be
    treated by moving the baby into colder environment and using loose light clothes for the
    baby. When the temperature is 37.5 0C -39 0C, undressing and exposing the neonate to
    room temperature is usually all that is necessary. If the temperature is above 39 0C, the
    neonate should be undressed and sponged with tepid water at approximately 35 0C until
    the temperature is below 38 0C. Monitor the temperature every hour.
    Neonates are prone to develop hypothermia due to
    - Large surface area
    - Decreased subcutaneous fat
    Methods of warming a neonate are
    - Kangaroo mother care ( skin to skin)
    - Radiant warmer
    - 200 watts bulb
    Hypothermia can be prevented by
    - Keeping the baby dry
    - Delaying the first bath upto 24 hrs
    - Keeping the room temperature >25 oC
    - providing adequate multiple layers of clothing
    CAUTION:
    Do not use warm water bottles to warm up/keep the baby
    warm. This can cause serious burns.
    Do not keep blower/heater too close to the baby for warming.
    VIDEO DEMONSTRATION ON KMC
    This video demonstrates the technique of Kangaroo mother care.

    10

    NATIONAL NEONATOLOGY FORUM

    EVALUATION

    1. Enumerate mechanisms of heat loss in neonates.


    a)

    b)

    c)

    d)

    2. The ten steps of warm chain include

    10

    3. Steps to prevent hypothermia include

    4. The normal temperature range is ___________________________________________

    5. Cold stress temperature range is ___________________________________________

    6. Moderate hypothermia temperature range is __________________________________

    11

    NATIONAL NEONATOLOGY FORUM

    You might also like