Radiant warmer in Neonates

A radiant warmer is a vital device used in neonatal care to maintain a newborn’s body temperature, especially for premature, low birth weight, or critically ill infants who cannot regulate their own heat.

Purpose of Radiant Warmers

• Provide external heat to prevent hypothermia
• Allow unrestricted access for procedures and monitoring
• Support thermoregulation during resuscitation or stabilization
• Reduce insensible water loss in very low birth weight infants

Preparation

• Educate the parents the importance of maintaining the body temperature.
• Discuss measures that will be used to maintain the newborn in a thermal neutral environment.

Procedure

•  Perform hand hygiene
• Connect the unit to the mains and switch it on
• Select manual mode. Select heater output to 100% for some time to allow quick prewarming of the bassinet covered with a linen.
• Select servo mode. Select the desired temperature of baby as 36.5°C.
• Place the baby in BaseNet
• Connect skin probe to the baby’s abdomen with sticking tape.
• If you want the manual mode to be used, select the desired heater output
• In manual mode, record baby’s axillary temperature.
• Check the sensor probe regularly so as to ensure that it is in place.
• Ensure that skin probe is free of contact with bed
• Cover probe with a reflective cover pad if available (foil covered foam adhesive pad)

General instructions

• Do not use warmer in cold room environment. It best works when the room temperature is above 20°C.
• Keeping the warmer where there is lot of air currents reduces its efficiency.
• The warmer must be prewarmed around 20 minutes before the arrival of the baby or till the temperature is reached with <50% of total heat output.
• While using the manual mode in a warmer without a temperature display, record the baby’s temperature regularly, preferably 92 hourly.
• The manual mode is used for initial preparations of bed for the baby or when rapid warming of a severely hypothermic temperature at 30 minutes and then 2 hourly.
• Respond to alarm immediately. Identify the fault and rectify it.

Application of skin probes

Do’s

• Prepare the skin using an alcohol/spirit swab to ensure good adhesion to the skin.
• Use of cling wrap (transparent polythene used for covering fruits or vegetables for storage) over the baby, tied across the panel warmer, has shown to reduce insensible water losses and result in better thermal control for very low birth weight (VLBW) (<1.5 kg) babies.

Don’ts

• Do not apply to bruised skin.
• Do not apply clear plastic dressing over probe.
• Do not use fingernails to remove skin surface probes.
• Do not reuse disposable probes.

Care of Radiant Warmer

• Surfaces of warmer should be cleaned daily with an antiseptic solution, such as glutaraldehyde.
• Spirit or other organic solvents must not be used to clean the glass side panels or display panel.
• For disinfection of probe isopropyl alcohol should be used.
• Every 7 days, after shifting of the baby to another cot, the equipment should be cleaned thoroughly, first by light detergent solution and then with an antiseptic solution.
• The control and power units should be calibrated q4-6 months.

Nurses Responsibility

• Axillary temperature must be recorded and documented as per nursery policy and compare this with depicted display temperature.
• If the baby is having fever, examine the baby carefully.
• A baby who is overheated due to radiant warmer will have his skin flushed and also his sole/palms will be warm to touch in addition to warm abdomen.
• Fever due to any illness will result in warm abdomen to touch but palms/soles.
• will be cold to touch. In addition, clinical examination reveals features that point toward sepsis in the baby.
• Offer the parents the option of skin-to-skin contact if infant is stable.

Safety Tips

• Never leave the warmer on in an empty bed
• Respond promptly to alarms (e.g., probe dislodgement)
• Avoid overheating—monitor for signs like flushed skin or tachycardia

REFERENCES

1. Annamma Jacob, Rekha, Jhadav Sonali Tarachand: Clinical Nursing Procedures: The Art of Nursing Practice, 5th Edition, March 2023, Jaypee Publishers, ISBN-13: 978-9356961845 ISBN-10: 9356961840
2. Omayalachi CON, Manual of Nursing Procedures and Practice, Vol 1, 3 Edition 2023, Published by Wolters Kluwer’s, ISBN: 978-9393553294
3. Sandra Nettina, Lippincott Manual of Nursing Practice, 11th Edition, January 2019, Published by Wolters Kluwer’s, ISBN-13:978-9388313285
4. Marcia London, Ruth Bindler, Principles of Paediatric Nursing: Caring for Children, 8th Edition, 2023, Pearson Publications, ISBN-13: 9780136859840
5. Naveen Bajaj, Rajesh Kumar, Manual of Newborn Nursing, 2nd Edition, 2023, Jaypee Publishers, ISBN:978-9354659294
6. Ernstmeyer K, Christman E, editors. Nursing Fundamentals [Internet]. 2nd edition. Eau Claire (WI): Chippewa Valley Technical College; 2024. PART IV, NURSING PROCESS. Available from: https://www.ncbi.nlm.nih.gov/books/NBK610818/

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