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HYPOTHERMIA
www.drjayeshpatidar.blogspot.com
Hypothermia occurs when the body
temperature drops below 36.5degree
Celsius (97.7 degree F), the lower
limit of normal range of 36.5 - 37.5
degree Celsius (97.8-99.5 degree
Fahrenheit).
www.drjayeshpatidar.blogspot.in
Distribution and incidence

Neonatal cold injury occurs throughout
the world, even in warm climates. In one
hospital during an 8-year study in
Ethiopia, 67% of low birth weight and
high-risk infants admitted to a special
care unit from outside were hypothermic.
In a large series of births in the provinces
in China the incidence of sclerema was 6.7
per thousand. High - risk factors were
prematurity and low birth weight
www.drjayeshpatidar.blogspot.in
General Risk Factors
> Incorrect care of the baby immediately after
birth.
> Separation of mother from baby after birth.
> The weight and gestational age of the infant.
> The place of the delivery and environmental
conditions.
> Inadequate warming procedures before and
during transport of the infant.
> Asphyxia, hypoxia, other illness of the baby,
> Inadequate warming procedure during
resuscitation.www.drjayeshpatidar.blogspot.in
Signs of Hypothermia
Early clinical signs which should arouse
suspicion of cold stress due to hypothermia
are:
(1) The feet are cold to the touch and
become cold before the body is cold;
(2) Weak sucking ability.
(3) Reduction in activity-lethargy; and
(4) A weak cry.
www.drjayeshpatidar.blogspot.in
If hypothermia persists:
(1) there is a risk of neonatal cold injury
(2) the infant usually becomes lethargic, with
slow, shallow and irregular respiration and a
slow heart rate (bradycardia) corresponding
to the degree of fall in body temperature.
(3)Hypoglycemia and metabolic acidosis may
develop.
(4) There is a real risk of death
www.drjayeshpatidar.blogspot.in
(5) The face and extremities may have a
bright red color while the rest of body
is pale; central cyanosis may be present.
(6) Sclerema, a hardening of the skin,
associated with reddening and edema is
seen mainly on the back and the limbs
but may cover the whole body.
www.drjayeshpatidar.blogspot.in
Loss of Heat
There are four ways a newborn may
lose heat to the environment:-
(1) Radiation
(2) Convection
(3) Conduction
(4) Evaporation
www.drjayeshpatidar.blogspot.in
Role of a Nurse
An important objective of appropriate
care of the newborn is to avoid
hypothermia from the moment of
birth, by using procedures that will
prevent heat loss and maintain the
temperature within the normal
range, thus conserving the infant’s
energy for growth and development.
www.drjayeshpatidar.blogspot.in
Hypothermia can be prevented by
(1) drying the infant immediately after
birth,
(2) placing indirect skin-to-skin contact
with mother,
(3) Covering both (mother & baby) with
heavy and clean blanket.
www.drjayeshpatidar.blogspot.in
warm chain
The “warm chain” is a concept
introduced to describe a set of interlinked
procedures, which will minimize the
likelihood of hypothermia. Failure to
implement any one of them will break the
chain and increase the possibility of
undesirable cooling of the infant.
www.drjayeshpatidar.blogspot.in
The link in the “warm chain” includes:
(1) Warm delivery room
(2) Immediate drying
(3) Skin-to-skin contact
(4) Breast-feeding
(5) Postpone bathing and weighing of the
newborn
(6) Appropriate clothing and bedding
(7) Keeping mother and baby together
(8) Warm resuscitation
(9) Training and awareness
www.drjayeshpatidar.blogspot.in
Conclusion
 If all newborn infants, including preterm and small
infants are carefully dried and given to their mother in
skin-to-skin contact immediately after delivery, the risk
of hypothermia is greatly reduced.
There is sufficient evidences to conclude that
immediate post delivery hypothermia is harmful to
newborn, increasing the risk of morbidity and
mortality.
 The information presented here provides a basis from
which managers and health care providers can develop
their own plans and procedures for the prevention and
management of hypothermia in the newborn
www.drjayeshpatidar.blogspot.in
Thank you
www.drjayeshpatidar.blogspot.in

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Hypothermia

  • 2. Hypothermia occurs when the body temperature drops below 36.5degree Celsius (97.7 degree F), the lower limit of normal range of 36.5 - 37.5 degree Celsius (97.8-99.5 degree Fahrenheit). www.drjayeshpatidar.blogspot.in
  • 3. Distribution and incidence  Neonatal cold injury occurs throughout the world, even in warm climates. In one hospital during an 8-year study in Ethiopia, 67% of low birth weight and high-risk infants admitted to a special care unit from outside were hypothermic. In a large series of births in the provinces in China the incidence of sclerema was 6.7 per thousand. High - risk factors were prematurity and low birth weight www.drjayeshpatidar.blogspot.in
  • 4. General Risk Factors > Incorrect care of the baby immediately after birth. > Separation of mother from baby after birth. > The weight and gestational age of the infant. > The place of the delivery and environmental conditions. > Inadequate warming procedures before and during transport of the infant. > Asphyxia, hypoxia, other illness of the baby, > Inadequate warming procedure during resuscitation.www.drjayeshpatidar.blogspot.in
  • 5. Signs of Hypothermia Early clinical signs which should arouse suspicion of cold stress due to hypothermia are: (1) The feet are cold to the touch and become cold before the body is cold; (2) Weak sucking ability. (3) Reduction in activity-lethargy; and (4) A weak cry. www.drjayeshpatidar.blogspot.in
  • 6. If hypothermia persists: (1) there is a risk of neonatal cold injury (2) the infant usually becomes lethargic, with slow, shallow and irregular respiration and a slow heart rate (bradycardia) corresponding to the degree of fall in body temperature. (3)Hypoglycemia and metabolic acidosis may develop. (4) There is a real risk of death www.drjayeshpatidar.blogspot.in
  • 7. (5) The face and extremities may have a bright red color while the rest of body is pale; central cyanosis may be present. (6) Sclerema, a hardening of the skin, associated with reddening and edema is seen mainly on the back and the limbs but may cover the whole body. www.drjayeshpatidar.blogspot.in
  • 8. Loss of Heat There are four ways a newborn may lose heat to the environment:- (1) Radiation (2) Convection (3) Conduction (4) Evaporation www.drjayeshpatidar.blogspot.in
  • 9. Role of a Nurse An important objective of appropriate care of the newborn is to avoid hypothermia from the moment of birth, by using procedures that will prevent heat loss and maintain the temperature within the normal range, thus conserving the infant’s energy for growth and development. www.drjayeshpatidar.blogspot.in
  • 10. Hypothermia can be prevented by (1) drying the infant immediately after birth, (2) placing indirect skin-to-skin contact with mother, (3) Covering both (mother & baby) with heavy and clean blanket. www.drjayeshpatidar.blogspot.in
  • 11. warm chain The “warm chain” is a concept introduced to describe a set of interlinked procedures, which will minimize the likelihood of hypothermia. Failure to implement any one of them will break the chain and increase the possibility of undesirable cooling of the infant. www.drjayeshpatidar.blogspot.in
  • 12. The link in the “warm chain” includes: (1) Warm delivery room (2) Immediate drying (3) Skin-to-skin contact (4) Breast-feeding (5) Postpone bathing and weighing of the newborn (6) Appropriate clothing and bedding (7) Keeping mother and baby together (8) Warm resuscitation (9) Training and awareness www.drjayeshpatidar.blogspot.in
  • 13. Conclusion  If all newborn infants, including preterm and small infants are carefully dried and given to their mother in skin-to-skin contact immediately after delivery, the risk of hypothermia is greatly reduced. There is sufficient evidences to conclude that immediate post delivery hypothermia is harmful to newborn, increasing the risk of morbidity and mortality.  The information presented here provides a basis from which managers and health care providers can develop their own plans and procedures for the prevention and management of hypothermia in the newborn www.drjayeshpatidar.blogspot.in