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Nov 2007 ACoRN © 2005-07 Thermoregulation Sequence
Nov 2007ACoRN © 2005-07
Nov 2007ACoRN © 2005-07 A lerting signs C ore steps O rganization of care R esponse N ext steps Thermoregulation Sequence S pecific management
Nov 2007ACoRN © 2005-07 Alerting Signs
Nov 2007ACoRN © 2005-07 Hypothermia All newborns are at risk for temperature instabilityAll newborns are at risk for temperature instability Babies at increased risk for hypothermia include:Babies at increased risk for hypothermia include: –unwell –preterm, especially LBW (<2000g) and VLBW (<1500g) –SGA –open lesions –ambient temperature is < 23 o C or air drafts exist –being cared for by us!
Nov 2007ACoRN © 2005-07 Hypothermia Cold stress can cause: irritable (initially) / lethargicirritable (initially) / lethargic pale, mottledpale, mottled metabolic acidosismetabolic acidosis hypoglycemia / hyperglycemiahypoglycemia / hyperglycemia respiratory distress, apnea, tachypnearespiratory distress, apnea, tachypnea bradycardia / tachycardiabradycardia / tachycardia vasoconstriction, hypoxia, shockvasoconstriction, hypoxia, shock
Nov 2007ACoRN © 2005-07 Hyperthermia Causes include:Causes include: –iatrogenic –maternal epidural –maternal hyperthermia –infection –CNS disorders –administration of PgE 1 Babies with intrapartum or neonatal hyperthermia are at increased risk of neurodevelopmental complicationsBabies with intrapartum or neonatal hyperthermia are at increased risk of neurodevelopmental complications
Nov 2007ACoRN © 2005-07 Core Steps
Nov 2007ACoRN © 2005-07 Organization of Care and Response
Nov 2007ACoRN © 2005-07 Specific Management
Nov 2007ACoRN © 2005-07 Choosing initial incubator temperature in first 12 hours of age Birth weight (grams) Air temperature setting o C (double wall, humidified incubator) < 750 39.5 (37.5) 750 to 1000 39.0 (37.0) 1000 to 1200 37.5 1200 to 1500 36.5 1500 to 2000 35.5 > 2000 34 Adapted from: Jaimovich DG, Vidyasagar D. Handbook Pediatric and Neonatal Transport Medicine (2d Edition). Philadelphia: Hanley & Belfus, Inc. 2002, p. 483 Initial incubator temperature
Nov 2007ACoRN © 2005-07 Heat loss
Nov 2007ACoRN © 2005-07 Heat loss prevention Conduction Pre-warm beddingPre-warm bedding Cover weigh scaleCover weigh scale Change wet bedding as soon as possible (eg oxyhoods)Change wet bedding as soon as possible (eg oxyhoods)Evaporation Use medium to high humidity in incubatorsUse medium to high humidity in incubators Place baby < 29 weeks gestation in plastic bagPlace baby < 29 weeks gestation in plastic bag Convection Ambient temperature ~ 25 o CAmbient temperature ~ 25 o C Avoid air drafts: air vents, open/swinging doorsAvoid air drafts: air vents, open/swinging doorsRadiation Flexed nested positionFlexed nested position Double wall incubatorDouble wall incubator
Nov 2007ACoRN © 2005-07 Keeping warm
Nov 2007ACoRN © 2005-07 Questions?
History of Thermoregulation §Incubation traced as far back as the Egyptians §Napoleon brought back to Parisian zoos §1800’s used for premature infants.
Teaching Aids: NNFNH-1 Hypothermia Significant problem in neonates at birth and beyond Mortality rate twice in hypothermic babies Contributes to significant.
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Newborn infant By : Dr.Sanjeev. Thermal protection in newborn Due to reduced subcutaneous and brown fat Brown fat : - Site : adrenal glands, kidneys,
Thermal protection in neonates. Teaching Aids: ENCNT-2 Hypothermia Significant problem in neonates at birth and beyond Contributes to significant morbidities.
Nov 2007 ACoRN © Infection Sequence. Nov 2007ACoRN ©
1 THERMOREGULATION IN THE NEONATE THERMOREGULATION IN THE NEONATE Mary DeBarbieris, RNC October, 2008.
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Lectur 7 Clinical aspects of Maternal and Child Nursing NUR 363.
1 HIPOTHERMIA Perinatology Division Dept. of Child Health Medical School University of Sumatera Utara.
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Neurohormonal of Thermoregulation Dr. Dini Sri Damayanti,MKes.
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Teaching Aids: NNF DS- 1 Danger Signs in Newborn.
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Respiratory Distress Syndrome (RDS) Fred Hill, MA, RRT.
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Neonatal A & P RC 290. Neonate Compared to Adult More compliant and flexible thorax Large tongue Large U-shaped epiglottis Narrowest part of upper.
Chapter 22 Physiologic and Behavioral Adaptations of the Newborn All Elsevier items and derived items © 2014, 2010, 2006, 2002, Mosby, Inc., an imprint.
JHPIEGO in partnership with Save the Children, Constella Futures, The Academy for Educational Development, The American College of Nurse-Midwives and Interchurch.
Neonatal emergencies Dr. Miada Mahmoud Rady. Hypoglycemia in newborn Definition : blood glucose level of less than 45 mg/dL in full-term or preterm newborns.
30,000 live births from Compared courses of babies of weeks to those of 39 weeks or longer.
Pediatric Fundamentals Prematurity Drs. Greg and Joy Loy Gordon January 2005.
Copyright © 2008 Wolters Kluwer Health | Lippincott Williams & Wilkins The Normal Newborn Chapter 12.
Unit 4: Medical Technologies. - any format of machinery that is used to operate or perform medical procedures.
Thermoregulation Dr. Harold Helbock. Thermoregulation Homeotherms use the: Environment Vascular and metabolic adaptations Shivering and sweating Cold-blooded.
Session 28 BREASTFEEDING LOW-BIRTH-WEIGHT AND SICK BABIES.
32-36 Week Infants Stacie Bennett, M.D. East Bay Newborn Specialists September 12, 2007.
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NeoWrap Preventing Hypothermia In Very Low Birth Weight Infants Cindy Peiffer St. Luke’s Hospital Cedar Rapids, Iowa.
Neonatal Sepsis Islamic University Nursing College.
Treating preterm infants with Surfactant: an overview of application techniques and results Angela Kribs, Children‘s Hospital, University of Cologne.
Neonatal Diseases Dr. Miada Mahmoud Rady EMS /481 Neonatal emergencies.
Critical Care Nursing A Holistic Approach Part 3.
Dr.Saeed Mahmoud MBBS, MRCOG, MRCPI, MIOG. Definitions Pregnancy dating Term / Gestational period Different species Labour True/False Effacement / Dilatation.
O UTCOMES R ESEARCH Providing the evidence for evidence-based medicine ©
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Doug Simkiss Associate Professor of Child Health Warwick Medical School The principles of good neonatal care and why neonatal resuscitation is important.
CARE OF THE LOW BIRTHWEIGHT BABIES /NEONATAL INTENSIVE CARE AGGREY WASUNNA Division Of Neonatal Medicine Department of Paediatrics & Child Health University.
Rafat Mosalli MD Abnormal Gestation. Objectives What is Normal gestation? What is Normal gestation? Newborn classification according to age and Weight.
Provincial Reciprocity Attainment Program Neonatal Assessment.
Homeostasis Anatomy and Physiology Unit 5 Sophie Bevan.
HYPOGLYCEMIA/ HYPERGLYCEMIA IN THE NEONATE What is the definition of a neonate? The first 30 days of an infants life or A premature infant that has not.
Care of the Late-Preterm Infant Constance Hymas CDR, NC, USN RNC-NIC, MN, MSHS, NNP-BC.
SEHS: Option A: A2 cont’d Environmental factors part II.
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Queen Dube Consultant Paediatrician Queen Elizabeth Hospital Blantyre Doug Simkiss Associate Professor of Child Health Warwick Medical School University.
The Late Preterm Infant (34 0/7 to 36 6/7 weeks) Physical Exam & Physiologic Challenges 1EB.
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