[dragonfly6352]

Hey Everyone,
I am currently working on a task force to raise our admission temperatures in our babies born <34 weeks. We are looking at several things that are contributing to the hypothermia and one of them is the hats. We use the old stocking style hats (pink, blue and white striped ones) in our delivery room. Our team has come to find that these have not been studied for use in the preemie and that they really don't hold that much heat in for the babies.
So, I was wondering what your NICU does for hats in the delivery room for your high risk babies. Any input would be great!! There's really no good info out there!

Thanks!

[preemieRNkate]

We still have the same hats and use them on all babies. One thing that we do that has made a big difference is that we use Neowraps for the micropreemies. It's basically a plastic bag that we put the baby in immediately following delivery. We don't even dry them.

[TiffyRN]

Yes, we are bagging our smaller kids and also we have these mattresses that are basically like a huge heelwarmer. We also use them for our post-ops.

[SteveRN21]

My last job used TransWarmers (big heel warmer-like thingies), and rarely had a problem with admission hypothermia if we got them on it quick enough. Here our only option is saran wrap and "french-fry lights"

[preemieRNkate]

We use the Transwarmer mattresses too. I especially like them for when we go out on transport in the winter. I went out in November for a 25 weeker, and not only did it keep him toasty, but it acted as a nice little shock absorber for the ambulance ride. I noticed much less artifact on the monitor and it was easier to obtain a BP.

[Sweeper933]

We use the stocking hats, neowrap, as well as the "gigantic heel warmer" ... We also admit all <29 week babies directly into the Giraffe beds. We bring the Giraffe beds down to L & D (they sit on our unit prewarming at 34 degrees at all times, stocked w/ supplies ready to go). Once we intubate and secure the ETT, we close the top of the bed while we are getting the surfactant ready. We also apply the temp probe and set it to 37 degrees. By closing the top of the bed several min before we are ready to transport back to our unit, they air inside the bed has a few min to warm up.

Once we put all of those things into practice, we starting finding that these micropremies temps upon admit to our unit were too high - that's where putting the temp probe on so early came into play.

[dragonfly6352]

Thanks for all the input. We use neowrap on all babies born <34 weeks already. The way our OR/LDR are set up, there is NO room to admit to the giraffe. They are prewarmeed and set up in our nursery as well. We do use a prewarmed transporter to get them to the NICU, which is a quick trip around the corner. We place them in radiant warmers and have been placing the probe on them at 37 degrees while in L&D, during resucitation and have found this is helping tons. We do not use the transwarmer mattresses, because they can cause burns. They can reach temps of 107 degrees, so our Neo group will not use them.
I think our biggest battle is being fought with L&D. They keep turning down the temps in the rooms to like in the 60s! When rooms should be set at 77. So, our Neo group and this task force is meeting with L&D and all the OBs next week to try and educate them on neonatal hypothermia. Ugh! What a mess. I'm glad this has just started happening and we caught it early enough and are heading it off at the pass. Thanks for all your input!

[Sweeper933]

Originally Posted by dragonfly6352

We do not use the transwarmer mattresses, because they can cause burns. They can reach temps of 107 degrees, so our Neo group will not use them.

We always place the warmers under the diaper cloths to prevent damage to their skin

[dawngloves]

Originally Posted by dragonfly6352

. We do not use the transwarmer mattresses, because they can cause burns. They can reach temps of 107 degrees, so our Neo group will not use them.

Really? We use it on all our ELBW deliveries and have never experienced that. I don't think it's even designed to go over 100 degrees. If you have issues, you should contact Drager. Maybe it was a bad lot.
We also just use the regular stocking hats and Neo Wrap. Most of our kids come to the unit normothermic. It's the 23-24 weekers that are usually cold on arrival.

[dragonfly6352]

On this task force, we got together articles that we found on thermo reg in neonates. One we found has a case study of 25 week twins that we placed on a warmer mattress of some kind, I can't remember what, that had a lower heating point than the Drager transwarmer mattresses. They both suffered full thickness 3rd degree burns and had to have skin grafts. I work with an uber conservative group on Neos and they just don't want to risk it. I WISH we could use these all the time!!! They worked great when we trialed them! Everyone on here is so knowledgeable! Thanks for your input!