Authors (including presenting author) :
Ching WYK (1), Ho KTC (1), Cheung SKM (1), Wong HY (1)
Affiliation :
(1) Department of Obstetrics and Gynaecology, St. Paul’s Hospital
Introduction :
Neonatal hypothermia is prevalent and is associated with neonatal morbidity and mortality, especially in newborns suffering from prematurity, severe infection and asphyxia. Despite full compliance with routine thermal care and interventions, it proved difficult to keep newborns warm. A drop in temperature was noted between the time of birth and admission to nursery, and the risk increased with longer duration of transport. Instant heated disposable (IHD) blankets are typically used in adult patients undergoing hypothermia or cardiac interventional procedures.
Objectives :
This project aimed to examine the application of IHD blanket in preventing neonatal hypothermia during transportation in the Department of Obstetrics and Gynaecology of St. Paul’s Hospital.
Methodology :
Recruited participants were term newborns delivered without birth complications. After delivery, the newborn was dried thoroughly and wrapped in warm towels. The pre-heated IHD blanket was then applied to the newborn before transporting from the delivery or operating room to the nursery in incubator. Outcome measures were: (1) rectal temperature using digital thermometer upon admission to nursery, and (2) maternal satisfaction level on the second day of delivery.
Result & Outcome :
From 6 March to 31 August 2019, a total of 672 newborns and 665 mothers were recruited. Regarding the first outcome, the mean rectal temperature using routine interventions and IHD blanket were 36.1°C and 36.5°C respectively. Warming was well tolerated with no cases of hyperthermia or dermal irritation. Incidence of moderate to severe neonatal hypothermia decreased from 15% to 10%. Regarding the second outcome, 76% of the mothers rated their satisfaction at high levels. Effective warming helped weaning newborns from incubator to open cot and promoted maternal-newborn bonding. By generating a predictable amount of heat instantly and maintaining warmth over a prolonged period of time, the IHD blanket aids prevention of neonatal hypothermia. It is preferred to other comparable devices because it is: (1) fully mobile which allows healthcare providers to transfer without any hassle, (2) disposable after use and does not disrupt infection control practices, (3) does not rely on electrical source, (4) compactly packaged with long shelf life, and (5) at a minimal operating and maintenance cost. It could potentially be a cost-effective thermal solution not only in hospitals but also out of hospitals such as during inter-hospital transfer for critically ill newborns. It would also be beneficial to explore product with longer heat duration for premature newborns having difficulty in heat reservation. However, there were two limitations: (1) access to newborns through the incubator armholes is more difficult with the use of IHD blanket, and (2) environmental concern due to its non-reusable nature.
