Initiation
> 36 weeks
At what gestational age do you initiate the cooling protocol?
Request cord gases
What lab will aid the management of HIE?
Lethargic, stupor or coma
What is the level of consciousness?
Turn the warmer off
What is passive cooling?
ET tube, stylet, CO2 detector, laryngoscope blade & handle, tape, suction, and neopuff
What supplies are needed for intubation?
< 6 hours old
What is the age cut off for starting the cooling process?
Targeted neurologic exam by provider
What does a provider use the Sarnat chart for?
Decreased activity or no activity
What is the level of spontaneous activity?
Hyperthermia
What should be avoided?
Rhythmic jerks, bicycling/swimming, posturing, nystagmus/blinking/fluttering, sucking/tongue protrusion, or apnea
What are signs of seizures?
pH 7.01-7.15 or base deficit 10-15.9
What blood gas values indicate cooling is needed?
Consult early
When should the provider consult for suspected HIE?
Distal flexion, complete extension, or decerebate
What is the posture of the baby?
15 minutes
How often should the core temperature be checked?
Phenobarbital
What medication can be used to treat newborns having a seizure?
10 minute apgar < or = to 5 or assisted ventilation for ten minutes or more
What length of resuscitation or apgar score inidcates the need for cooling?
33-35 degrees C
What is the targeted temperature range?
Hypotonia or flaccid
What is the tone of the baby?
Overcooling
What is something else that should be avoided?
Perinatal Regional Center
Who should be consulted?
Seizures or moderate-severe encephalopathy
What medical diagnosis would be another indicator to start the cooling protocol?
Arrhythmias, coagulopathy, pulmonary htn, electrolytes abnormalities, and hemodynamic instability
What are adverse effects that can result from overcooling?
weak suck or incomplete moro OR absent suck or moro
What is are primitive reflexes present?
33-35 degrees C
What is the targeted temperature range?
Four hours
What is the time frame by which the newborn should be transferred to a higher level of care?