An interesting debate has broken out in our department over hypothermia in infants 0-30 days of age. The case in question was a 4d old who presented for jaundice and was noted to have a temp of 36.2C rectal in triage, 35.8C rectal when moved to the exam room. The mother said the baby had been feeding poorly and wasn't very active but the baby looked fine in the ED. Some docs have said they would perform a full r/o sepsis eval. Others have felt that as an isolated finding the low temp was not worth pulling the trigger since the child had a normal exam otherwise.
1. What is hypothermia in this age group? Some have cited <36.5, other <36.02. Is hypothermia as iron-clad an indication for r/o sepsis as fever? We perform the r/o sepsis eval for 100.4F or greater even if everything else is perfectly fine. Is it the same for hypothermia?3. Does the complaint of jaundice, which we know can be caused by infection, change anyone's approach to the low temp?
Appreciate everyone's expertise and input.
James Reingold, M.D.
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