Human touch to detect hypothermia in neonates in Indian slum dwellings

Agarwal, Siddharth; Sethi, Vani; Srivastava, Karishma; Jha, Prabhat; Baqui, Abdullah H

doi:10.1007/s12098-010-0115-0

Cited by 10 publications

(5 citation statements)

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“…Studies in India and Nepal have shown human touch to be reasonably reliable for the detection of hypothermia when health workers were trained for these investigations. [45][46][47][48][49] Mothers, however, seem to have a far lower sensitivity than health workers. Only 24% of mothers in India were able to correctly identify hypothermia.…”

Section: Diagnosismentioning

confidence: 99%

Thermal protection of the newborn in resource-limited environments

2012

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Appropriate thermal protection of the newborn prevents hypothermia and its associated burden of morbidity and mortality. Yet, current global birth practices tend to not adequately address this challenge. Here, we discuss the pathophysiology of hypothermia in the newborn, its prevention and therapeutic options with particular attention to resource-limited environments. Newborns are equipped with sophisticated mechanisms of body temperature regulation. Neonatal thermoregulation is a critical function for newborn survival, regulated in the hypothalamus and mediated by endocrine pathways. Hypothermia activates cellular metabolism through shivering and nonshivering thermogenesis. In newborns, optimal temperature ranges are narrow and thermoregulatory mechanisms easily overwhelmed, particularly in premature and low-birth weight infants. Hyperthermia most commonly is associated with dehydration and potentially sepsis. The lack of thermal protection promptly leads to hypothermia, which is associated with detrimental metabolic and other pathophysiological processes. Simple thermal protection strategies are feasible at community and institutional levels in resource-limited environments. Appropriate interventions include skin-to-skin care, breastfeeding and protective clothing or devices. Due to poor provider training and limited awareness of the problem, appropriate thermal care of the newborn is often neglected in many settings. Education and appropriate devices might foster improved hypothermia management through mothers, birth attendants and health care workers. Integration of relatively simple thermal protection interventions into existing mother and child health programs can effectively prevent newborn hypothermia even in resource-limited environments.

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Section: Diagnosismentioning

confidence: 99%

Thermal protection of the newborn in resource-limited environments

2012

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“…1 In India, the prevalence of hypothermia varies widely but recent estimates in normal newborns in community settings are around 31% and about 32% in hospital settings, but these included mostly normal weight newborns. 2,3 The prevalence can be estimated to be even higher for low birth weight newborns. Approximately 27 Jagadish AS et al Int J Contemp Pediatr.…”

Section: Introductionmentioning

confidence: 99%

A randomized control trial of hypothermia alert device in low birth weight newborns and the effect on kangaroo mother care and weight gain

Jagadish

Benakappa

et al. 2019

Int J Contemp Pediatr

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Background: Lack of thermal protection is one of the major challenges faced by developing nations for newborn survival. Early detection and subsequent prevention of hypothermia through Kangaroo Care could lead to significant health outcomes for the newborn. Hypothermia alert device is a bracelet that monitors for early hypothermia by sensing the extremities and sounding an alarm for parents to take action.Methods: In a randomized controlled trial, the effect of the hypothermia alert device on KMC compliance at home and weight gain of newborns on 4th week follow-up was evaluated. New borns discharged from the neonatal intensive care unit at Indira Gandhi Institute of Child Health (IGICH). Neonates who were LBW (less than 2500 grams) were included in the study once they were stable and ready for discharge. Neonates were given a hypothermia alert device to monitor their temperatures for hypothermia for 4 weeks. Weekly follow-ups were held with parents and to record measurements of growth. Additionally, parents were given a KMC diary to track sessions of KMC. Neonates were given either a placebo bracelet or a BEMPU Bracelet. Bracelets were identical and both monitored for hypothermia, however only the BEMPU Bracelet gave an alarm when the newborn was hypothermic.Results: Statistically 44 neonates completed the 4-week trial; 23 were in the control group and 21 were in the BEMPU group; of these, 19 participants in the control group completed KMC diaries and 19 BEMPU group completed KMC diaries. The results of the clinical trial reveal that parents of neonates in the BEMPU group demonstrated better compliance to KMC. In the BEMPU group, the average daily time spent doing KMC was significantly higher in first (3.02 v 1.96 h, p=0.016) and fourth (3.04 v 2.38 h, p=0.094) week of discharge. There was an increase of weight gain in the BEMPU group after the first (25.7 v 20.7 g, p=0.1.85) and fourth (28.3 v 22.9 g, p=0.057) week of discharge.Conclusions: The hypothermia alert device was found to be an effective intervention to promote parent adherence to Kangaroo Care and weight gain.

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“…Ellis et al ( 15 ) emphasize the need for further palpation and monitoring if the baby is thought to be cold based on human touch. The accuracy of human touch increases when conducted by trained workers ( 14 , 17 ) and pediatricians ( 18 ), with all pediatricians in one study found to be capable of correctly identifying all hypothermic babies.…”

Section: Resultsmentioning

confidence: 99%

Temperature Monitoring Devices in Neonates

2021

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Introduction: Accurate temperature monitoring of neonates is vital due to the significant morbidities and mortality associated with neonatal hypothermia. Many studies have compared different thermometers in neonates, however, there is a lack of consensus regarding which of the currently available thermometers is most suitable for use in neonates.Objectives: The aim of this review was to identify and compare current methods available for temperature monitoring of neonates beyond the delivery room, including the accuracy, advantages and disadvantages of each.Methods: A recent search and narrative synthesis of relevant studies published between January 1, 1949 and May 5, 2021 on the OVID Medline, PubMed and Google Scholar databases.Results: A total of 160 papers were retrieved for narrative synthesis. The main methods available for temperature monitoring in neonates are human touch and mercury-in-glass, electronic, infrared tympanic and other infrared thermometers. Newer innovations that are also available include liquid crystal thermometers and the BEMPU TempWatch. This paper discusses the current evidence available regarding the utility of these devices, and identifies barriers to valid comparison of different thermometry methods.Conclusion: Many methods for temperature monitoring in neonates are currently available, each with their own advantages and disadvantages. However, the accuracies of different devices are hard to determine due to variable methodologies used in relevant studies and hence, further research that addresses these gaps is needed.

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Human touch to detect hypothermia in neonates in Indian slum dwellings

Cited by 10 publications

References 1 publication

Thermal protection of the newborn in resource-limited environments

Thermal protection of the newborn in resource-limited environments

A randomized control trial of hypothermia alert device in low birth weight newborns and the effect on kangaroo mother care and weight gain

Temperature Monitoring Devices in Neonates

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