Cath toes

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?

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.

I've heard both, but really, I've only had warming the foot work a couple of times.

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!

Plus warming the unaffected foot lets the affected foot be uncovered and visible.

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.

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.

We also put a thin dab of NitroPaste on the affected toes to try to avoid D/C'ing the line.

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.

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