Cincinnati Sub-Zero

Developing a Standard of Care Protocol for Treating HIE in the Neonatal ICU

By CSZ, A Gentherm Company On Jun 11, 2018 3:00:00 PM

shutterstock_1033753660During our podcast interview with Jennifer Norgaard RN, a NICU clinical nurse specialist at a level IV NICU in California, we learned about the process of setting up protocols to treat infants with hypoxic-ischemic encephalopathy (HIE). Norgaard explained that some centers see only a few of these babies each year while others see many more. In either case, HIE is not one of the more common diagnoses seen in the NICU.

Begin With Research

A great place to start is by reviewing research and study protocols developed by professionals who use and understand hypothermic treatments for neonates. Be sure to cover the criteria for inclusion as well as contraindications for care. Some suggested high-level resources include:

Beyond these references, there is a significant amount of additional information available on this topic. When creating a protocol, take time to conduct a thorough review of all available resources. This Medscape comprehensive literature review is directed toward nurse clinicians and contains valuable information for creating standard of care treatment protocols for HIE.

Talk To Experienced Treatment Providers

The majority of hypothermic treatment for HIE is done at Level 3 NICUs. These centers are excellent resources and transfer of the infant to one of them may be the best choice for optimal care. However, attaining a successful outcome for HIE treatment is extremely time-dependent, so the first steps may likely need to be taken at your own facility. You need to have protocols in place for initiating care. Ask area referral centers to assist you in creating a local protocol for the immediate care and transfer of these infants for time-sensitive treatments. They may be able to share existing protocols and possibly assist with onsite training. It is also important to understand the families' need for support during the various phases of this episode of care.

Understand The Equipment

What types of therapeutic hypothermia products are available to you? Contact equipment manufacturers and ask local equipment vendors for product recommendations and training resources for neonatal hypothermic treatments. Many vendors can recommend not only products but also training partners and additional educational materials.

Creating a protocol starts with research and mentorship. Reach out to therapeutic hypothermia experts who are experienced with HIE and review all of the available resources before creating a protocol of your own.

Temperature Management in Neonatal Care

*This article is intended for educational purposes only and is not intended as medical advice or as a substitute for the medical judgment of a physician in evaluating patients. For more information, please review the information sources referenced in this article. For more information on CSZ, please visit our website or call us at 1-800-989-7373.