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Clinician Management Practices for Infants With Hypothermia in the Emergency Department

Sriram Ramgopal1, Christopher Graves2,3, Paul L Aronson4

  • 1Division of Emergency Medicine, Ann & Robert H. Lurie Children's Hospital of Chicago, Northwestern University Feinberg School of Medicine, Chicago, Illinois.

Pediatrics
|November 27, 2023
PubMed

Insights

Clinician testing and treatment for infants with hypothermia varies by age, with younger infants receiving more diagnostic tests. Management patterns for hypothermic infants may need further research and implementation.

Area of Science:

  • Pediatrics
  • Infectious Diseases
  • Emergency Medicine

Background:

  • Hypothermia in young infants can indicate serious bacterial infections (SBI) or herpes simplex virus (HSV) infections.
  • Emergency departments (ED) are common points of care for these infants.

Purpose of the Study:

  • To evaluate emergency department clinician testing and treatment preferences for infants presenting with hypothermia.
  • To understand how age influences management decisions for hypothermic infants.

Main Methods:

  • A survey was developed and distributed to clinicians in 32 US pediatric hospitals.
  • Survey responses from 1231 clinicians (63.6% completion rate) were analyzed.
  • Management preferences were stratified by infant age (≤60 days).

Main Results:

  • Clinicians reported lower confidence managing hypothermic infants compared to febrile infants.
  • Testing rates (e.g., blood tests for SBI, HSV tests) were higher for neonates (0-7 days) than for older infants (22-60 days).
  • Similar age-dependent patterns were observed for respiratory viral testing, hospitalization, and antibiotic use.

Conclusions:

  • Infant hypothermia management, including testing and treatment, varies significantly by age.
  • Clinical preferences for hypothermic infants often mirror practices used for febrile infants.
  • Identified management patterns warrant further research and potential implementation efforts.
Abstract

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