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  • Title: Assessment of newborn baby's temperature by human touch: a potentially useful primary care strategy.
    Author: Singh M, Rao G, Malhotra AK, Deorari AK.
    Journal: Indian Pediatr; 1992 Apr; 29(4):449-52. PubMed ID: 1506096.
    Abstract:
    Fifty healthy term neonates delivered at All India Institute of Medical Sciences Hospital were assessed by three pediatricians for skin temperature to the nearest +/- 0.5 degrees C at the three body sites, i.e., mid-forehead, abdomen and dorsum of right foot by touch. The predicted temperatures at different sites were compared with simultaneously recorded temperatures at the same sites with the help of an electronic thermometer having a sensitivity of +/- 0.1 degree C. Rectal temperature was also recorded in all the babies with a rectal thermister to compare the variations between the core and skin temperatures. There was a good correlation between the skin temperatures of the babies as perceived by touch and values recorded with the help of an electronic thermometer. All the hypothermic babies were correctly picked up by all the observers. There was good correlation between core temperature and skin temperature at different sites except forehead. It is amazing that even during the month of May, when ambient temperature was maintained between 26-28 degrees C, nearly one fifth of the healthy term babies were under cold stress as evidenced by greater than 2 degrees C difference between the core and peripheral skin temperatures. It is recommended that health professionals and mothers should be explained the importance of evaluating the core and peripheral skin temperature by touch for early identification of babies under cold stress in order to prevent occurrence of life threatening hypothermia. At the All India Institute of Medical Sciences Hospital in New Delhi, India, in May 1990, 3 pediatricians experienced with newborns used either the back or palm of their hand to assess the body temperature of 50 full term, healthy newborns at 3 different sites (center of the forehead, abdomen, and back of right foot). At the same time, another health professional used a digital electronic thermometer to measure the temperature at each site and a special rectal probe to measure core temperature. The ambient temperature ranged from 26 to 28 degrees Celsius. The foot temperature was 1.43 degrees Celsius lower than the core temperature. The pediatricians were able to adequately correlate skin temperatures determined by their touch with those determined by digital thermometer (abdomen [p .005] and foot [p .05]). Experience of the pediatrician was related to their ability to correctly sense the skin temperature. Sensitivity of perceiving a skin temperature at the abdomen of less than 36 degrees Celsius was 100% and specificity was about 90%. The abdominal skin and core temperature of just 1 newborn was less than 36 degrees Celsius. 10 newborns had a foot temperature which was more than 2 degrees Celsius lower than the core temperature indicating cold stress. Their feet tended to be pale, whereas warm feet were pink. These findings suggested that mothers, traditional birth attendants, nurses, and physicians can successfully undergo training to assess newborn's temperature by touching the abdomen and feet. They must learn that cold feet and cold abdomen denote hypothermia and require immediate attention. After training, they need to conduct field research to validate these findings.
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