Thermoregulation and regularity of temp checks?

Specialties NICU

Published

Hi all

Just wondered what people's practice was regarding temperature taking. We are told to promote minimal handling and therefore some people are taking it for gospel that they can't touch baby to record temperature- at the minute we record axilla temp usually with cares for a baby who has been with us a few days. Initially it is important particularly when a new preemie comes in or on humidity etc etc to check temp much more often than just with cares. However I understand that babies need to be left to get some settled sleep however knowing the complications of hypothermia and hyperthermia I am reluctant to leave temp recording for as long as some of the older nurses in our unit do, sometimes going as long as 12 hours without a temp!! I was thinking if suggesting to my manager about the potential for using the skin temp ( we have a transport incubator that does this and as far as I'm aware our other incubators allow this) or a nasal temperature probe attached to a monitor to allow us to get a real time temp reading making titration (particularly on humidity or phototherapy) much easier.

Any thoughts or ideas would be appreciated

Specializes in NICU, PICU, PACU.

I've never heard of an isolette without ISC capability or of a baby being burned by a probe. Is she sure it wasn't a warmer left on manual and it cooked the kid and heated up the disc so much it burned, although that would be hard to do too if people were paying attention. And if you get micronates, you should certainly be using a temp probe...too hot they can get an IVH amongst things! Same for cold. NTE is a standard of care across the board. Something just doesn't sound right.

We do axillary temp checks with every hands-on assessment, be it Q3, Q4, Q6..even minimum stimulation.

This is can be a first sign that a baby is going downhill. I have seen defective isolettes, which is another reasons for checking it regardless if a baby is on a temp probe or not.

This is can be a first sign that a baby is going downhill. I have seen defective isolettes, which is another reasons for checking it regardless if a baby is on a temp probe or not.

Yes true! I got report on a little guy once (1kg or so) and the night RN told me she was having trouble with his isolette all night, that it kept alarming that he was cold but he wasn't. Well when I went in isolette was around 40 degrees inside and freaking out about it (alarms, lights) so I checked baby assuming he was cooking and I couldn't get a temp at all! The temp probe and isolette were working just fine. Stat labs showed obvious sepsis and kid was on dopa/epi and the oscillator by the time I went to lunch (around 5pm...) of course I was paired with another baby because this one has been a "stable vent". Nightmarish day.

Yes true! I got report on a little guy once (1kg or so) and the night RN told me she was having trouble with his isolette all night, that it kept alarming that he was cold but he wasn't. Well when I went in isolette was around 40 degrees inside and freaking out about it (alarms, lights) so I checked baby assuming he was cooking and I couldn't get a temp at all! The temp probe and isolette were working just fine. Stat labs showed obvious sepsis and kid was on dopa/epi and the oscillator by the time I went to lunch (around 5pm...) of course I was paired with another baby because this one has been a "stable vent". Nightmarish day.

TEXTBOOK example of why temperature checks are important!!!!!!

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