Premie Warm Welcome Protocol

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All Infants < 32 weeks Gestational Age


  • Place chemical mattress and polyurethane bag on ‘bed’ prior to delivery. Note: Activate mattress just prior to delivery. Cover the mattress with one nursery baby blanket. Place bag on top of blankets.
  • After delivery, place infant directly in plastic bag without drying.
  • Temporarily place skin temp probe on upper chest. You may need to gently dry that area. Direct cable to come out top of bag for easy connection to isolette servo when available.
  • Ensure plastic bag covers as much of baby as possible (up to neck)-with good seal at top and bottom to prevent draft and evaporative heat loss.
  • Keep baby in on chemical mattress and in bag until stabilization and transport is completed. ***Note: Remove mattress if chest compressions are needed.
  • Cover head with saran wrap. Don’t block radiant heat with care giving activities.
  • Begin axillary temperature monitoring: at 5min & then every 30 minutes, If baby is placed in isolette and skin temp probe is accurate and has been correlating with previous axillary temps, it is acceptable to measure skin temperature.

STEP 2: Sat Probe and Respiratory Resuscitation/Stabilization.

  • Apply SAT probe. You may be able to place on limb over bag if bag sticks to skin well. If unable, create opening in bag and secure probe through opening.
  • If indicated, wipe face gently to prepare for intubation. Apply Duoderm (if available) on upper lip to attach ETT tape to
  • Use estimated fetal weight based on gestational age. Do not try to weigh small premies in the village unless absolutely necessary as they get VERY hypothermic.

STEP 3: Keep bag in place for stabilization procedures and transport:

UA/UV Placement:

  • Create opening in plastic.
  • Keep bag on infant when preparing sterile field and doing procedure.

Peripheral Line Placement:

  • Create opening in bag for access to limb for PIV placement. Secure to IV board.

Newborn Common Scenarios/Special Situations
Newborn Emergency Stabilization Workflow
Medevacs for the Inpatient Pediatrician