Hypothermia

preemieRNkate, RN · Apr 4, 2008

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, BSN, PhD · Apr 4, 2008

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.

SteveNNP, MSN, NP · Apr 4, 2008

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, RN · Apr 4, 2008

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 · Apr 4, 2008

We use the stocking hats, neowrap, as well as the "gigantic heel warmer" ... We also admit all

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 · Apr 4, 2008

Thanks for all the input. We use neowrap on all babies born

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 · Apr 4, 2008

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, BSN, RN · Apr 4, 2008

. 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 · Apr 4, 2008

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!

SteveNNP, MSN, NP · Apr 5, 2008

They both suffered full thickness 3rd degree burns and had to have skin grafts. !

We always used to wrap the Transwarmers in a pillowcase. Their max heating point is like, 99f!

elizabells, BSN, RN · Apr 5, 2008

Even with only saran wrap and "french fry lights" (hee!) I've found that if I get a peanut who can't bring herself up to temp pretty quickly, it is a bad sign of things to come. Usually our limited options work okay for me.