Infants and Hypothermia

Nurses General Nursing

Published

This may seem silly to ask, but I am throwing it out here.

How concerned would you be if a 5 lb., 1 week old was maintaining her body temp. at only 92?

I understand that hypothermia can put babies at risk for hypoglycemia, decreased perfusion, and even hemorrhage, but the doc. acted like this temp. wasn't too concerning and sent the baby home. Would you be concerned? Why or why not?

Thanks in advance everyone!:redbeathe

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Specializes in Maternal - Child Health.

We cannot give medical advice here on Allnurses.

But any baby with a body temperature of 92 degrees needs to be seen in the ER immediately.

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I'm not seeking "medical advice." I work as a student nurse in a peds. office and a new mom brought in this baby. I thought it was strange to send her home like that. He told her to call if she got down to 90 (which would be 90 axillary-not even core!) I just wanted to know the rationale or if others would be concerned as I was.

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Specializes in NICU.

The only time a body temp. that low is acceptable is when an infant is on a cooling blanket. Temp instability (esp "getting cold") can indicate sepsis in infants. The infant should have been slowly rewarmed and at least a cbc imo. But I am JTN (just the nurse) so what do I know....

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Specializes in OB/Neonatal, Med/Surg, Instructor.

I would have been very concerned and would have discussed my concerns with the ER physician who may not be savvy about the dangers of hypothermia in small babies, especially neonates (babies under a month old for the students/visitors). Neonates are often hypothermic when they are battling an infection rather than hyperthermic. Never assume a physician knows something; diplomatically and professionally discuss your concerns. I have done so on numerous ocassions, especially with ER and non-pediatrician MDs, regarding neonates and found they were not familiar with the nuances involved in treating or managing the care of newborns and almost always were grateful for the heads up. A couple of them wanted to see it in writing (thankfully we had access to the internet and some reliable websites) before they changed their plan of care, but done professionally as a collaborative team effort, they were appreciative. The one who wasn't and proceeded with a course that was 100% wrong required us to follow the chain of command all the way to the administrator of the hospital in order to transfer a very sick infant to a level III NICU for care. As a student you would discuss the matter with your clinical instructor and the nurse you were working with and let them address your concerns with the physician. :nurse:

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Specializes in OB/Neonatal, Med/Surg, Instructor.

Sorry, I just re-read and saw it was a peds office...with a board certified pediatrician???? Wow.:confused:

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Specializes in Maternal - Child Health.
I'm not seeking "medical advice." I work as a student nurse in a peds. office and a new mom brought in this baby. I thought it was strange to send her home like that. He told her to call if she got down to 90 (which would be 90 axillary-not even core!) I just wanted to know the rationale or if others would be concerned as I was.

Sorry I jumped to conclusions.

I agree with everything the other posters have written, and double that for a baby who is apparently either a preemie or was small for gestational age, putting her at even greater risk of the complications of hypothermia.

Unless we're missing some pertinent information here, the pediatrician dropped the ball, and I would be very concerned for the well-being of this baby.

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As a PICU/NICU nurse for 25 years, I would be very concerned about this infant, A temp of 92 is not "normal" The only time I have seen a temp that low has been a near drowning or someone who is post-arrest.This infant needs to be evaluated, it could be sepsis, maybe something congenital involving the hypothalmus. Was the infant active with good color or was she lethargic? Was the temp rechecked to make sure the thermometer was functioning? And telling the mom to return with a temp of 90 is even scarier!:nurse:

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Specializes in ER.

Absolutely would not let that baby leave, or if I did it would be with instructions to go another ER with a sane doc. I would be concerned about the baby surviving the trip.

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Specializes in Community, OB, Nursery.

Nope, not good. Echoing all the other posters' concerns - this is not a normal, esp given the baby's size and/or possible gestational age.

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Specializes in Emergency & Trauma/Adult ICU.
He told her to call if she got down to 90 (which would be 90 axillary-not even core!)

90 degrees axillary is about 92 degrees core temp. The office reading of 92 degrees axillary is about 94 degrees core temp. Does this make a difference for anyone.

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Specializes in Maternal - Child Health.
90 degrees axillary is about 92 degrees core temp. The office reading of 92 degrees axillary is about 94 degrees core temp. Does this make a difference for anyone.

Nope. Still dangerously low, and a possible sign of decompensation due to serious illness such as sepsis and/or neurological impairment.

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