Radiant warmers

Specialties NICU

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I have a question that has been in "debate" on my unit for along time so I thought I'd ask the "experts"-the NICU nurses.....

In my OB dept some of the nurses say that hats should not be applied to infants under a radiant warmer and others disagree. I checked with the company (Hillrom) and they didn't see a problem with using hats but didn't seem very positive. I realize that you should never place anything between the warming module and the temp probe but are hats ok???

We put nothing but a diaper on the babies we have under the warmers.

I want to add to this question. WHY can't you put anything in between the babe/probe and the warmer? I read the manual that comes with the unit, and it just says not to... no reasoning. What about when you have babes that just need to be under the warmer when not held or eating due to LBW or something? I have, on occasion, kept them dressed, unwrapped, and with servo on, and just checked temp q2 hrs and it always reads the same.

what about when you turn them on their side? The manual states to keep the probe on the "liver area" of the skin. But this doesn't make sense if they are on their right side, as the probe wouldn't be in direct "view" of the warmer.....

It just confuses the heck outta me!

One of the first things I do at a delivery is put a hat on the baby. Don't they lose like 40% of their body heat through their head?

And if the are on servo, what's the difference?

Even in an isollette, I put them in swaddled, with a hat on and on air temp until they are 36c or so and then give them their first bath then warm them up again before they go to mom.

Can't rationale the temp probe thing either? What is the difference there too?

And I thought your were NOT to put the probe over the liver? Would give a false high reading.

Originally posted by dawngloves

And I thought your were NOT to put the probe over the liver? Would give a false high reading.

That's what I thought to.

Heather

hmmm, I'm positive its what our manual, and p&p says to do. Maybe different warmers are different? The last place I worked, where I learned l&d and nursery, told me to put it over any place on the abdomen other than bony areas.

Specializes in NICU, Infection Control.

I think it's ok to dress them on a warmer--the probe just needs to go on the abd, if it's over the liver, the docs can't examine it as easily. The servo will adjust. And I think the hat prevents evaporative loses. On a real immature premie, you can pull the hat down and cover their eyes a bit for light protection, also.

Specializes in NICU.

It seems like if the temp probe is accurately reading the baby's body temperature, and the control is set to auto rather than servo, it wouldn't matter if the hat OR clothing or swaddling were on the baby, because the probe would automatically accommodate for the baby's increased temperature. On ours, we put the probe on any fleshy area. Our manuals don't state a particular place (i.e., over the liver, etc.) to place the probes, but our warmers are as old as Charlton Heston. ;>)

Specializes in NICU, PICU, PACU.

We put hats on the kids, but we don't dress them, usually if they are on a warmer they warrant frequent watching anyways. The only ones that we dress are the really bad neuro kids that can't keep a temp and we want to see what they are doing temp wise.

We usually end up sticking the probe under the kids armpit...we tend to roast our kids on the warmers LOL The abd temp can be 1 degree C higher than the pit.

I tried to reply once and it was lost...so one more time!

We have no problem using warmers and putting hats on the baby. In fact many of our nasal cpap babes are on warmers still, as we tend to extubate soon even micropremies...after the first head u/s and fairly stable.

We use airshields and also use the single use probe with a little heart cover that is easy on the skin. Also when placing the probe don't put it over the liver...it will read a false high...the liver gives heat!

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