Cath toes

  1. This may be a dumb question, but can someone accurately explain why the opposite foot is warmed if a baby has cath toes, and never the affected foot? As a new grad, I was taught warming the opposite foot is correct, but am working somewhere now that puts heel warmers on both feet. I thought this process was wrong, but wanted to be sure of my theory before saying something.
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  2. 16 Comments

  3. by   Mags4711
    Interesting you are being taught to warm both feet, the NIH and an articale on MedScape just list warming the opposite foot to cause a reflex vasodilatation. Wonder if it's the result of a new study?
  4. by   Jolie
    If you apply a warmer to the affected foot, you are increasing the metabolic demands of that extremity at a time when the circulation is less than optimal. That could theoretically lead to tissue damage.

    By applying a warmer to the opposite foot, you get the benefit of increased blood flow to the affected extremity (by way of reflex vasodilation) without increasing its metabolic demands.
  5. by   dawngloves
    I've heard both, but really, I've only had warming the foot work a couple of times.
  6. by   prmenrs
    I think it may be more imp't to fix the line placement than to warm feet. (I, too, was taught to warm only the unaffected foot. You might also try a position change for the baby to see if that affects where the line is lying.)
  7. by   Gompers
    Quote from Jolie
    If you apply a warmer to the affected foot, you are increasing the metabolic demands of that extremity at a time when the circulation is less than optimal. That could theoretically lead to tissue damage.

    By applying a warmer to the opposite foot, you get the benefit of increased blood flow to the affected extremity (by way of reflex vasodilation) without increasing its metabolic demands.

    Great answer!
  8. by   KRVRN
    Plus warming the unaffected foot lets the affected foot be uncovered and visible.
  9. by   lovemyjob
    I was reading an article, think it was in Advances in neonatal care, that talked about the risks of losing the toes/foot/limb and suggests that if ther is any question, the line should be pulled. I know that is in a perfect world, sometimes the risk outweighs the benefit..

    Jolie, I appreciate your answer...always wondered why warming the affected foot was a bad idea.
  10. by   ncbeachgrl
    Thanks for the responses! I too, had often wondered about not warming the affecting foot, but knew I had only been taught to warm the unaffected foot. You're right, if the baby really does have "cath toes", the best thing to do is pull the line.
  11. by   KRVRN
    We also put a thin dab of NitroPaste on the affected toes to try to avoid D/C'ing the line.
  12. by   danissa
    Have been a nicu midwife for a LONG time, but in scotland! So, maybe a lost in translation thingy, but what do you mean by "cath toes"???
  13. by   Jokerhill
    We also protect the feet by placing a cover over them in a tent fashion if the baby is under a radiant warmer. With poor circulation the heat will not be transfered away and can be burnt by the warmer.

    Cath toes is poor circulation/toes turning purple, with a UAC/UVC being the most logical cause.
  14. by   missapoo
    we have a doc that has used nitro paste over the entire affected extremity...I thought that was a little much but it did seem to work well. We usually pull the line if there is any question of compromise. Along the same lines, this same doc won't let us put any diapers on babies with lines because he thinks they will get a fungal infection...has anyone encountered this? I just think he is full of BS personally lol
    I mean really, have you ever tried to catch pee and poop from going everywhere when you can't use a diaper? Our beds are constantly needing changing etc...not to mention we can't get accurate outputs. Sorry for my griping LOL

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