336 Section IX ■ Miscellaneous Procedures

degree and duration can be individualized to

infant’s clinical condition in this mode.

(2) To select controlled rewarm mode, press menu,

select mode, press ▲ to move up or to move

down, and highlight the controlled rewarm

option. Press OK (Fig. 45.13C).

The message “CORE readout too low check

core and operate” will appear (Fig. 45.13D).

Core, skin, and target temperatures are

shown on the monitor of the temperature management unit (Fig. 45.13D). The water will no

longer be circulating in the wrap. The default

target temperature is 36.5°C; however, the set

target temperature can be varied between 36°C

and 38°C, using the ▲ or ▼ arrows below the

target temperature read out (Fig. 45.13D).

(a) To start controlled rewarming, press menu

and use the ▲ or ▼ arrows to select

Operation (Fig. 45.13E).

(b) Once Operation is highlighted, press the

Enter button to confirm (Fig. 45.13E).

(c) Once normothermia achieved, leave the

infant on the wrap for 12 hours.

(d) If the infant is in a crib in which the temperature of the mattress can be increased,

increase the temperature of the mattress to

1°C above the infant core temperature at

the end of the 12-hour period and remove

the wrap.

(e) Keep the infant’s head uncovered and

placed on the bubble wrap pillow to insulate the head from the heated mattress.

(f) Infant may be dressed in one layer of clothing.

(g) Monitor the rectal temperature for 24 hours

after achieving normothermia (approximately

36.5°C rectal) to avoid hypo- or hyperthermia.

Precautions

a. The CureWrap must be applied loosely (allow a

space of a finger width between the skin and the

wrap) around the trunk to avoid impeding ventilation and pressure on the skin from the monitoring

leads between the wrap and skin (Fig. 45.15).

b. Skin care must be performed a minimum of every

8 hours.

B

A

C

Fig. 45.14. Insulating the head with bubble wrap. A: Pillow is prepared with six layers of bubble wrap.

B: The layers of bubble wrap are rolled at one end to form a neck roll. C: CureWrap placed around the

doll; bubble wrap pillow is covered with sheet; the neck rests on the neck roll; aEEG electrode is fixed in

the parietal (P3) position.

Chapter 45 ■ Brain and Whole Body Cooling 337

c. An alarm will alert the user if the rectal or surface

probes become dislodged.

d. An alarm will sound if there is insufficient water in

the temperature management unit.