Following birth, an unstable body temperature is often an initial indicator of a problem with the newborn's health. As a result, every newborn—especially at-risk full-term and preterm newborns—receive extra clinical care and attention for thermal management following delivery.
Thermal management frequently involves caring for a newborn with radiant warmers or incubators. These medical devices directly measure a newborn's skin temperature at the site where disposable skin temperature probes are secured, typically the adbdomen or chest. Skin temperature is a critical clinical parameter: it continuously tracks the newborn's temperature in response to environmental changes that impact their body heat. Detection of temperature abnormalities is paramount for newborns struggling with thermoregulation, as sharp and sudden temperature changes can significantly impact their health.1
However, with effective clinical care, defined clinical processes, and medical technology, clinicians can help newborns maintain their temperatures in a safe and healthy range: between 36.5°C and 37.5°C, as recommended by the Neonatal Resuscitation Program's guidelines.2
Monitoring Newborns for Thermal Stress
Achieving newborn thermoregulation can be a challenge. Newborns cannot shiver; they also have underdeveloped skin and sweat glands, large surface-to-body mass ratios, and higher metabolic rates. Additionally, if neonates are transferred from their warmer or incubator to another space for tests, scans, or exams, environmental impacts such as the NICU's circulating air and cold surfaces can exacerbate temperature regulation difficulties.
Preterm infants have a 28 percent higher risk of death for every 1°C drop in temperature on admission to the NICU.3 In these critical moments, clinicians need to ensure measures are taken to avoid heat loss—for example, employing supportive warming devices such as blankets, hats, and plastic wraps; warming the room temperature; and prewarming surfaces and equipment. Avoiding hypothermia is imperative, as low temperatures in newborns have been associated with increased oxygen consumption, increased glucose utilization, growth impairment, neurological concerns, and sepsis.4
Employing a high-quality skin temperature probe can help reduce the need for unnecessary medical interventions. When provided with continuous, live data on the baby's temperature while in BABY/SERVO mode, "smart" incubators or warmers with state-of-the-art technological algorithms which can automatically adjust the internal bed's temperature to the newborn's needs. Based on the thermometer probe's readings, the algorithm will adjust the warmer or incubator's heat output up or down with no alarms or manual assistance required. Device trend screens also allow clinicians to assess the warmer or incubator temperature and track patient skin temperature to identify periods of instability and stability.
Ensuring Accurate Readings with Proper Placement
Temperature probe placement is vital to proper probe function. Various studies have examined probe placement, but most recommendations come from practice guidelines and manufacturer's recommendations, according to research published in Advances in Neonatal Care.5
Suggested best practices for skin temperature probe placement include:6,7,8
- Avoid bony prominences, which can result in skin breakdown.
- Avoid placement underneath the infant between the mattress, which can result in what is known as "insulation."
- Ensure that the probe remains in full contact with the infant's skin.
- Cover the probe with a heat reflective patch to reflect direct radiant heat sources from the skin temperature probe sensor tip.
- Place bed in Air Mode prior to removing the probe for repositioning or a bath. If the bed is left in Baby Mode when probe is removed, the bed will respond to the change in temperature detected by the probe.
GE Healthcare's disposable skin temperature probes are wide and flat, creating a full, sizeable, and reliable attachment to the infant's skin. The sensor probe tip has two temperature sensors which ensure the accuracy of the temperature measurements displayed. Clinicians can adhere the disposable skin temperature probe to the skin from either side, so there is no "wrong way" to attach the temperature probe.
When paired with GE-compatible heat-reflecting patches, the disposable skin temperature probes are also easy to position and secure. And will ensure consistent and reliable skin temperature measurements, when used as directed. Furthermore, disposing of the disposable skin temperature probe after every single patient use reduces the care unit workload of cleaning and disinfecting reusable devices between patients.
Making Every Part Count
Radiant warmers and incubators support a critical and daily need for newborns. Using a system that features a newborn warmer or incubator, skin disposable temperature probes, and a heat-reflecting patch helps to ensure the newborn can maintain a desired thermal range.
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References
1. Cavallin, F., Calgaro, S., Brugnolaro, V. et al. Impact of temperature change from admission to day one on neonatal mortality in a low-resource setting. BMC Pregnancy Childbirth 20, 646 (2020). https://doi.org/10.1186/s12884-020-03343-7
2. Khalid Aziz, Chair; Henry C. Lee, Marilyn B. Escobedo, Amber V. Hoover, Beena D. Kamath-Rayne, Vishal S. Kapadia, David J. Magid, Susan Niermeyer, Georg M. Schmölzer, Edgardo Szyld, Gary M. Weiner, Myra H. Wyckoff, Nicole K. Yamada, Jeanette Zaichkin; Part 5: Neonatal Resuscitation 2020 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. Pediatrics January 2021 https://doi.org/10.1542/peds.2020-038505E.
3. Sharma, D. Golden hour of neonatal life: Need of the hour. Maternal health, neonatal and perinatal 3, 16 (2017). https://doi.org/10.1186/s40748-017-0057-x.
4. Hypothermia in Neonates. Pediatrics. MSD Manual Professional Edition https://www.merckmanuals.com/professional/pediatrics/perinatal-problems/hypothermia-in-neonates#v36188756.
5. Joseph RA, Derstine S, Killian M. Ideal Site for Skin Temperature Probe Placement on Infants in the NICU: A Review of Literature. Adv Neonatal Care. 2017 Apr;17(2):114-122. https://pubmed.ncbi.nlm.nih.gov/28092317/.
6. Schafer D, Boogaart S, Johnson L, et al. Comparison of neonatal skin sensor temperatures with axillary temperature: does skin sensor placement really matter? Advances in Neonatal Care: Official Journal of the National Association of Neonatal Nurses. 2014 Feb;14(1):52-60. https://europepmc.org/article/MED/24472889.
7. Dowling, Donna PhD, RN, Section Editor. Research Abstracts From the 2016 NANN Research Summit, Advances in Neonatal Care. June 2016 - Volume 16 - Issue 3 - p E3-E12 doi:10.1097/ANC.0000000000000287.
8. Sinclair JC. Servo‐control for maintaining abdominal skin temperature at 36C in low birth weight infants. Cochrane Database of Systematic Reviews 2002, Issue 1. https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD001074/full.
