2. Newborn baby is homeothermic,but his ability to stay warm may
easily by extreme of environmental temperature.
Neonatal hypothermia often due to lack of attention by health
providers, continues to be a very important cause of neonatal
deaths.
INTRODUCTION
3. Contd…….
A new born is more prone to develop hypothermia because of
large surface area per unit of body weight.
A low birth weight baby develops hypothermia easily because of
decreased thermal insulation due to less subcutaneous fat &
reduced amount of brown fat.
5. CLASSIFICATION
Acc. to severity, hypothermia is classified as,
1. Cold stress- 36.0 ˚c to 36.4˚ c
2. Moderate Hypothermia- 32.0˚c to 35.9˚c
3. Severe hypothermia - <32˚c
8. DIAGNOSTIC EVALVUATION
Temperature Recording –
a) Axillary temperature :-
It is accurate as rectal temperature & probably safer (less
risk of injury or infection ) .
It is recorded by placing the bulb of thermometer against
the roof of dry axilla free from mother.
9. b) Rectal Temperature
This method is not used for routine monitoring.
The thermometer is kept in place at least for 02 minutes .
10. c) Skin Temperature
Skin temperature is recorded by a thermister .
The probe of thermister is attached to the skin over
upper abdomen.
Warm & pink feet of the baby indicate that baby is in
thermal comfort.
11. MANAGEMENT
A hypothermic baby has to be rewarmed as quickly as possible .
The method selected will depend the severity of hypothermia &
availability of staff & equipments.
12. The method used to manage cold stress include,-
A warm room or bed
Skin-skin contact
A 200 watt bulb
A radiant heater or an incubator
13. In case of Moderate hypothermia
(>32to >36˚c)
Skin to skin contact should be in a warm room & warm bed.
Warmer /incubator may be used ,if available ,continue rewarming till
temperature reaches normal range . Monitor every 15-30 minutes.
14. In case of Severe hypothermia (<32˚c)
Use air heated incubator or
manually operated radiant warmer or
thermostatically controlled heated mattress set at 37-38˚c.
15. Prevention of Hypothermia
Acc. to the concept of “warm chain” baby must be kept warm at the
place of birth ( home or hospital) & during transportation for special
care either from home to hospital or with in the hospital.
It is a set of 10 interlinked procedures carried out at birth & later
,which will minimize the likelihood of hypothermia in all newborns.
16. 1. Warm delivery room (>25˚c)
2. Warm resuscitation.
3. Immediate drying .
4. Skin-skin contact between baby & the mother.
5. Breast feeding .
6. Bathing & weighing.
7. Appropriate clothing & bedding .
8. Mother & baby together .
9. Warm transportation .
10. Training /awareness of health care providers.
17. Temperature maintenance during transport
Always stabilize the baby’s temperature before transport.
Record temperature before transport .
Carry the baby close of mother.
Cover head ,legs & hands.
Avoid undressing the infant for cleaning ,weighing or examination .
18. Contd…
1. In the delivery room:-
Conduct delivery in a warm room.
Immediately dry the newborn with a clean soft preferably warm
towel.
Ensure that the head is well covered.
Keep the baby by the mother’s side.
19. 2. skin-skin contact ( the kangaroo method ) ‘’kangarooing”
Assists in maintaining the temperature of infant.
Facilitates breast feeding.
Helps to increase the duration of breast feeding.
Improves mother-infant bonding.
20. 3.Bathing the baby-
Bathing immediately after birth should be avoided. Ensure before
giving bath baby’s temperature should be normal.
Bath is given to normal baby on second day in summers.
The nurse should follows the instruction for bathing as given
below;-
Use warm room & warm water.
Bath quickly & gently
Dry quickly & wrap in a warm ,dry towel.
