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Purpose To determine if implementing a normothermia bundle, which includes preoperative forced-air warming blankets, reduces incidence of inadvertent perioperative hypothermia (IPH). Design Intervention study using retrospective chart review. Methods Patients received a preoperative forced-air warming blanket and temperature management with the normothermia bundle. Temperature status data was collected from patient charts to evaluate the incidences of IPH and findings from this data analysis was used to measure improvement in perioperative temperature management. Findings Of 200 patients, 63 (31.5%) remained normothermic, 37 (18.5%) had at least one documented hypothermic temperature, and 100 (50%) had no documented temperature during the intraoperative phase of care. Although compliance with intraoperative temperature monitoring decreased by 13% postintervention, the incidence of documented IPH in reviewed records was decreased by 3.6-fold. Conclusion Implementing a normothermia bundle that includes a preoperative forced-air warming blanket may lower the incidences of IPH, especially in surgical cases lasting over 120 minutes.

Background: Microwave heating can be effective in preventing cytomegalovirus infection transmitted via human milk. Temperature changes during microwaving using different containers, in different areas inside a container, or using milk from different mothers are not well studied. Research Aim: To determine temperature changes of human milk during microwaving using different containers, in different container areas, using different human milk, and in a 30-ml soft polypropylene bag (sachet) immersed in water. Methods: In this experimental in vitro study, human milk (100 ml) was poured into six different bottles. The temperature was monitored simultaneously at each bottle’s bottom and surface (microwaving at 600 W) and at nine places inside the container (microwaving at 500 W). Human milk (20 ml) from six participants was inserted into a sachet, then immersed in 80 ml of human milk or water in a bottle, and the temperatures inside and outside the sachet during microwaving (at 500 W) were monitored. Results: The temperature changes at the surface were significantly larger than those at the bottom. Temperatures at the bottoms of different bottles, of human milk from different participants, or inside and outside the sachet, did not differ significantly. No temperature outliers inside the bottle were observed. Conclusion: Microwaving at 500 W and 600 W for 60 s was not significantly different in temperature changes among different areas inside bottles or among milk from different participants. A small volume of human milk (up to 100 mL) can be heated using a sachet.

Background: Low-cost care strategies can be implemented to avert the morbidity and mortality associated with hypother- mia in preterm neonates. Objective: To determine the effect of massage therapy on body temperature of preterm neonates. Methods: A quasi-experimental design was conducted among 72 preterm neonates at a level II special care nursery in Western Kenya. Neonates were recruited on the third day of life and followed up for 10 days. Neonates in the intervention group were massaged three times a day for 15 minutes. Body temperature was monitored and recorded before, during and after each therapy session. Neonates in the control group received routine care: temperature monitoring three times a day, feeding and diaper change. Results: Neonates who received massage had higher mean body temperature than the control group during therapy on day 6 (p = .019) and after therapy on day 6 (p = .017) and day 8 (p = .005). A comparison within massage group (before/during, during/after, before/after) showed an increase in mean body temperature during therapy compared to before therapy (p

A new hot balloon system that registers balloon surface temperature (BST) during energy delivery is now available for clinical use in Japan. This study sought to investigate the utility of BST measurement for achievement of pulmonary vein isolation (PVI) by a single-shot energy delivery strategy during hot balloon ablation (HBA).We applied and tested the system in 30 consecutive patients undergoing HBA for paroxysmal or early-persistent atrial fibrillation (AF). We also performed real-time PV potential monitoring using a circular catheter.Acute PVI was achieved with single hot balloon shots in 88% (106/120) of the PVs. Real-time BSTs and PV potentials were recorded in all cases. Mean BST at documentation of PVI was 49.4°C, and acute reconnections were observed in most cases (86%, 12/14) in which the single-shot technique was ineffective. Time-to-isolation (TTI) (23.1 ± 8.7 s vs. 36.3 ± 9.3 s, p .01) and median BST (59.9 ± 2.6°C vs. 55.7 ± 1.9°C, p .01) differed significantly between cases in which PVI was achieved (vs. those in which PVI was not achieved). Multivariable analysis revealed strong association between both TTI and median BST and acute PVI. The best median BST cutoff value for achieving PVI with a single shot was58.7°C (sensitivity 67.0%, specificity 100%).Our data suggest that real-time BST monitoring during energy applications is useful for predicting achievement of acute PVI by a single shot during HBA.

Judy Munday,1,2 Niall Higgins,1,3 Lee Jones,1,4 Dimitrios Vagenas,4 André Van Zundert,1,5,6 Samantha Keogh1,3 1School of Nursing & Centre for Healthcare Transformation, Faculty of Health, Queensland University of Technology, Kelvin Grove, QLD, Australia; 2Department of Health and Nursing Science, Faculty of Health and Sports Sciences, University of Agder, Grimstad, Norway; 3Royal Brisbane and Women’s Hospital, Herston, QLD, Australia; 4Research Methods Group, Institute of Health and Biomedical Innovation (IHBI), Faculty of Health, Queensland University of Technology, Kelvin Grove, QLD, Australia; 5Department of Anaesthesia and Perioperative Medicine, Royal Brisbane and Women’s Hospital, Brisbane, QLD, Australia; 6School of Medicine, The University of Queensland, Brisbane, Australia & Queensland University of Technology, Brisbane, QLD, AustraliaCorrespondence: Judy MundaySchool of Nursing & Centre for Healthcare Transformation, Queensland University of Technology, Rm 529, Level 5, N Block, Kelvin Grove, QLD, 4059, AustraliaTel +61 73138 8209Fax +61 3138 3814Email judy.munday@qut.edu.auPurpose: Perioperative hypothermia prevention requires regular, accurate, and consistent temperature monitoring. Zero-heat-flux (ZHF) thermometry offers a non-invasive, measurement method that can be applied across all surgical phases. The purpose of this study was to measure agreement between the zero-heat-flux device and esophageal monitoring, sensitivity, and specificity to detect hypothermia and patient acceptability amongst patients undergoing upper and lower limb orthopedic surgery.Patients and Methods: This prospective, observational study utilized Bland–Altman analysis and Lin’s concordance coefficient to measure agreement between devices, sensitivity and specificity to detect hypothermia and assessed patient acceptability amongst 30 patients between December 2018 and June 2019.Results: Bias was observed between devices via Bland Altman, with bias dependent on actual temperature. The mean difference ranged from − 0.16°C at 34.9°C (where the mean of ZHF was lower than the esophageal device) to 0.46°C at 37.25°C (where the mean of ZHF was higher than esophageal device), with 95% limits of agreement (max) upper LOA = 0.80 to 1.41, lower LOA = − 1.12 to − 0.50. Seventy-five percentage of zero-heat-flux measurements were within 0.5°C of esophageal readings. Patient acceptability was high; 96% (n=27) stated that the device was comfortable.Conclusion: ZHF device achieved lesser measurement accuracy with core (esophageal) temperature compared to earlier findings. Nonetheless, due to continuous capability, non-invasiveness and patient reported acceptability, the device warrants further evaluation.Title Registration: The study was registered at www.ANZCTR.org.au (reference: ACTRN12619000842167).Keywords: perioperative, thermoregulation, thermometry, sensitivity, specificity

To assess the accuracy and precision of infrared cameras compared to traditional measures of temperature measurement in a temperature, humidity, and distance controlled intensive care unit (ICU) population. This was a prospective, observational methods comparison study in a single centre ICU in Metropolitan Melbourne, Australia. A convenience sample of 39 patients admitted to a single room equipped with two ceiling mounted thermal imaging cameras was assessed, comparing measured cutaneous facial temperature via thermal camera to clinical temperature standards. Uncorrected correlation of camera measurement to clinical standard in all cases was poor, with the maximum reported correlation 0.24 (Wide-angle Lens to Bladder temperature). Using the wide-angle lens, mean differences were − 11.1 °C (LoA − 14.68 to − 7.51), − 11.1 °C ( − 14.3 to − 7.9), and − 11.2 °C ( − 15.23 to − 7.19) for axillary, bladder, and oral comparisons respectively (Fig. 1a). With respect to the narrow-angle lens compared to the axillary, bladder and oral temperatures, mean differences were − 7.6 °C ( − 11.2 to − 4.0), − 7.5 °C ( − 12.1 to − 2.9), and − 7.9 °C ( − 11.6 to − 4.2) respectively. AUCs for the wide-angle lens and narrow-angle lens ranged from 0.53 to 0.70 and 0.59 to 0.79 respectively, with axillary temperature demonstrating the greatest values. Infrared thermography is a poor predictor of patient temperature as measured by existing clinical standards. It has a moderate ability to discriminate fever. It is unclear if this would be sensitive enough for infection screening purposes.Fig. 1Bland–Altman plots for temperatures measured using clinical standards to infrared camera. a Wide-angle camera versus bladder temperature. b Narrow-angle camera versus bladder temperature Supplementary Information The online version contains supplementary material available at 10.1007/s10877-021-00731-y.

Image-guided high-intensity focused ultrasound (HIFU) has been increasingly used in medicine over the past few decades, and several systems for such have become commercially available. HIFU has passed regulatory approval around the world for the ablation of various solid tumors, the treatment of neurologic diseases, and the palliative management of bone metastases. The mechanical and thermal effects of focused ultrasound provide a possibility for histotripsy, supportive radiation therapy, and targeted drug delivery. The integration of imaging modalities into HIFU systems allows for precise temperature monitoring and accurate treatment planning, increasing the safety and efficiency of treatment. Preclinical and clinical results have demonstrated the potential of image-guided HIFU to reduce adverse effects and increase the quality of life postoperatively. Interventional nuclear image–guided HIFU is an attractive noninvasive option for the future.

Inaccurate placement of the ablation catheter and the inability to monitor the real-time temperature within the tissue of interest such as veins curbs the treatment efficacy of laser ablation procedures during thermal therapies. Our previous studies have validated the efficacy of photoacoustic (PA) imaging during endovenous laser ablation (EVLA) procedures. However, the PA-guided therapies suffer from low temporal resolution, due to the low pulse repetition rates of pulsed lasers, which could cause a problem during fast catheter motion and rapid temperature changes. Herein, to enhance the accuracy and sensitivity for tracking the ablation catheter tip and temperature monitoring, we proposed to develop a high frame rate (500 Hz), combined ultrasound (US), and PA-guided ablation system. The proposed PA-guided ablation system was evaluated in a set of ex vivo tissue studies. The developed system provides a 2 ms temporal resolution for tracking and monitoring the ablation catheter tip’s location and temperature, which is 50 times higher temporal resolution compared to the previously proposed 10 Hz system. The proposed system also provided more accurate feedback about the temperature variations during rapid temperature increments of 10°C per 250 ms. The co-registered US and PA images have an imaging resolution of about 200 μm and a field of view of 45 × 40 mm2. Tracking the ablation catheter tip in an excised tissue layer shows higher accuracy during a relatively fast catheter motion (0.5–3 mm/s). The fast US/PA-guided ablation system will potentially enhance the outcome of ablation procedures by providing location and temperature feedback.

BACKGROUND Previously, we recorded periods of time with foot higher than abdominal temperatures in association with infection in preterm infants. Monitoring dual temperatures may be an important tool to assess infant instability. Currently, incubators cannot measure and display dual temperatures in servo-control mode. PURPOSE To examine the usability of GE Healthcare's Giraffe OmniBed with research software to measure, display, and record dual temperatures, and their differences while in servo-control. In addition, nurses' perceptions of the use and display of dual temperatures and differences were evaluated. METHODS A multiple-case, mixed-methods design. Abdominal and foot temperatures were measured, displayed, and stored for 28 days for 14 preterm infants. Nurses were surveyed for satisfaction and preferences with the dual temperature display. Nurses noted abnormal temperature differences and infant condition in bedside journals. RESULTS Study infants were 26 to 31 weeks of gestational age and 670 to 1410 g. Abdominal, foot, and the abdominal-foot temperature difference was measured, recorded, and downloaded successfully in all infants over all days. Nurses liked using dual temperature display with the abdominal-foot temperature difference. Surveys indicated preferences for larger displays and alarms for abnormal values. Thermal instability, stimulation, and thermistor detachment were associated with abnormal thermal gradients. Two exemplar cases are presented. IMPLICATIONS FOR PRACTICE Monitoring dual temperatures adds information to the clinical assessment. IMPLICATIONS FOR RESEARCH Studies are needed to examine relationships between abnormal thermal gradients and infections, infant stability, and nursing care along with the underlying physiologic mechanisms. Studies are needed for wireless dual temperature monitoring.

Background: Immunization success rates can be determined by several factors. The factors that can cause occurrences of immunization preventable disease (PD3I) cases include the quality of the cold chain and invalid doses of immunization medicines. Purpose: The aim of this research was to analyze the implementation of cold chain management in the city of Surabaya. Methods: This research was conducted as a descriptive study with a cross-sectional research design. The population consisted of all primary health care centers in the city of Surabaya, and the data used were secondary data, guided by interviews with informants. Results: The majority of cold chain management personnel were found to have a medical education background of 98.42%, and primary health care workers have received cold chain-related training (100%). All primary health care equipment has a 100% cold chain. The completeness of cold chain reporting was 93.51%, and the accuracy of the cold chain reporting was 71.52%. Regarding the quality of the equipment, some vaccine refrigerators were found 12% of vaccine refrigerators were found not to be in optimal condition, and 14% of temperature monitoring devices was not activated. Conclusion: The implementation of cold chain management in public health center and the availability of equipment in the Surabaya City are going well, although there are still some problems such as undisciplined reporting and inadequate quality of tools for cold chain implementation as well as the discovery of vaccine refrigerators easily leaks, and their temperature can rise easily.

There is an increasing interest in using precision dairy technologies (PDT) to monitor real-time animal behavior and physiology in livestock systems around the world. Although PDT in adult cattle is extensively reviewed, PDT use for the management of preweaned dairy calves has not been reviewed. We systematically reviewed research on the use and application of precision technologies in calves. Accelerometers have the potential to be used to monitor lying behavior, step activity, and rumination, which are useful to detect changes in behavior that may be indicative of disease, responses to painful procedures, or positive welfare behaviors such as play. Automated calf feeding systems can control delivery of nutritional plans to individualize feeding and weaning of calves; changes in feeding behaviors (such as milk intake, drinking speed, and unrewarded visits) may also be used to identify early onset of disease. The PDT devices also measure physiological and physical attributes in dairy calves. For instance, temperature monitoring devices such as infrared thermography, ruminal boluses, and implanted microchips have been assessed in calves, but no herd management-based commercial system is available. Many other PDT are in development with potential to be used in dairy calf management, such as image and acoustic-based monitoring, real-time location, and use of enrichment items for monitoring positive emotional states. We conclude that PDT have great potential for application in dairy calf management, enabling precise behavioral and physiological monitoring, targeted feeding programs, and identification of calves with poor health or behavioral impairments. We strongly encourage further development and validation of commercially available technologies for on-farm application of the monitoring of dairy calf welfare, performance, and health.

An ultraviolet curable glue (UCG)-filled microprobe Fabry–Perot fiber temperature sensor, which based on the two-beam interference principle, is proposed and fabricated. In the range of 25.7–250 °C, the average sensitivity and average linear correlation coefficient of the sensor are −41.69 pm/°C and 0.98558, respectively. Under the same temperature, the maximum fluctuation (0.56 pm) of the trough’s wavelength and the standard error (0.0023 ± 0.04%) are obtained. The proposed interferometer exhibits excellent stability and has a potential application in the field of temperature monitoring.

Objective. General cryotherapy effect on the human body with cooling gas is a physiotherapy method, the positive effect of which has been proven for more than 40 years of use (including in Russia, which is one of the leaders in this field). The objective of the study was to assess the prospects for the development of technical support for cryomedical effects on human organs. Methods. The work presents an overview and analysis of the current state of the technical support of this cryomethod. Results. The prospects for the method development and directions for improving the equipment are shown. It is noted that the development of the method is limited primarily by the lack of accuracy of cryotherapy and relatively high cost. Conclusion. Low-temperature therapeutic equipment can potentially be located not only in medical, cosmetology, sports facilities but also in office centers. The key in this direction is the development of technical support capabilities, which will further allow practitioners to impulse the development of methods for applying cryotherapy with cooling gas in the mass use of this physical factor in medicine.

Aims The aim of the study was to determine the incidence of oesophageal lesions after radiofrequency ablation (RFA) of atrial fibrillation (AF) with or without the use of oesophageal temperature probes. Methods and results Two hundred patients were prospectively randomized into two groups: the OPERA+ group underwent RFA using oesophageal probes (SensiTherm™); the OPERA− group received RFA using fixed energy levels of 25 W at the posterior wall without an oesophageal probe. All patients underwent post-interventional endoscopy and Holter-electrocardiogram after 6 months. (Clinical.Trials.gov: NCT03246594). One hundred patients were randomized in OPERA+ and 100 patients in OPERA−. The drop-out rate was 10%. In total, 18/180 (10%) patients developed endoscopically diagnosed oesophageal lesions (EDEL). There was no difference between the groups with 10/90 (11%) EDEL in OPERA+ vs. 8/90 (9%) in OPERA− (P = 0.62). Despite the higher power delivered at the posterior wall in OPERA+ [28 ± 4 vs. 25 ± 2 W (P = 0.001)], the average EDEL size was equal [5.7 ± 2.6 vs. 4.5 ± 1.7 mm (P = 0.38)]. The peak temperature did not correlate with EDEL size. During follow-up, no patient died. Only one patient in OPERA− required a specific therapy for treatment of the lesion. Cumulative AF recurrence after 6 (3–13) months was 28/87 (32%) vs. 34/88 (39%), P = 0.541. Conclusion This first randomized study demonstrates that intraoesophageal temperature monitoring using the SensiTherm™ probe does not affect the probability of developing EDEL. The peak temperature measured by the thermoprobe seems not to correlate with the incidence of EDEL. Empiric energy reduction at the posterior wall did not affect the efficacy of the procedure.

BACKGROUND Smaller preterm infants often receive extra attention with implementation of additional thermoregulation interventions in the delivery room. Yet, these bundles of interventions have largely remained understudied in larger infants. PURPOSE The purpose of this study was to evaluate initial (or admission) temperatures of infants born weighing 1500 g or more with diagnoses requiring admission to the neonatal intensive care unit (NICU). METHODS Retrospective medical record review of 388 infants weighing 1500 g or more admitted to the NICU between January 2016 and June 2017. RESULT In total, 42.5% of infants weighing 1500 g or more were admitted hypothermic (

Background Temperature modulating devices (TMD) currently utilize core temperature measurements during targeted temperature management (TTM) that are currently limited to esophageal (Et), bladder (Bt), or rectal (Rt) temperatures. We assessed the ability of a continuous noninvasive temperature monitor to accurately approximate core temperature during TTM. Methods All patients undergoing TTM using a gel pad surface TMD and an existing core temperature monitoring device were eligible for this study. Core and continuous noninvasive temperature monitoring values were simultaneously recorded for up to 72 h of TTM. The two sets of temperature data were downloaded from a clinical data acquisition storage system at 1-min intervals. The Bland–Altman method assessed agreement between the core and continuous noninvasive temperature monitor values, by measuring the mean difference (± 2 SD) between these values. Results There were 20 subjects that underwent study between January 2018 and March 2018 (55% women, age: 57 ± 14 years old, BMI: 28.9 + 9.8 kg/m2, 100% mechanically ventilated). The comparison patient temperature source was predominantly esophageal (n = 10) followed by bladder (n = 5) or rectal (n = 5). There were a total of 999 h of paired patient temperature data from esophageal (50%), bladder (25%), and rectal (25%) temperatures. Bland–Altman analysis demonstrated good agreement with the superficial temperature monitor and core temperature measures in all patients overall, with a difference mean of 0.06 ± 0.39 C (P = 0.99) and no proportional bias noted (β =0.002, P = 0.917). Conclusions Continuous noninvasive temperature monitoring is a suitable alternative method for assessing core temperature during TTM. Future studies should focus on developing connectivity with a continuous noninvasive temperature monitor to approximate core temperature during TTM.

Coronavirus pandemic has drastically upended the daily life routines of human beings and has wide wide-ranging effects on entire sectors of society. The food sector is also susceptible and substantially harmed by the influence of intensive effects of coronavirus. To ensure food safety and limit the spread of coronavirus at food services and retail sector has become a challenge where delicate and fresh food items are served and delivered to the customers, which have passed through a series of operational steps from order taking, food receiving, preparation of food, packing, delivery to customers. At each step, there is a possibility of food handlers to touch the food surface or food directly and if food handler is not following appropriate precautionary measures e.g. hand hygiene, sanitization and disinfection, social distances, and is touching, then it can be a possible source of coronavirus spread. Since there is no evidence that food is a coronavirus transmission route but during the food operations, improper sanitization and disinfection of key touchpoints, food contact, nonfood contact, equipment and cleaning tools surfaces and close contact of food handlers with staff and customers not only can put themselves on risk but can also be a risk for customers. Food services and the retail sector should make sure proper hand hygiene, approved sanitizers and disinfectants in use, follow social distances at workstations and while interacting with the customers. Finally, the business should be vigilant to monitor the temperature of staff and incoming guests to identify if there may any sick person to avoid from further spread of coronavirus and shall report to concerned health authorities if anyone symptoms matching with COVID-19.

BackgroundPerioperative hypothermia is an unintended decrease in the core temperature of patients. Hypothermia has many proven complications. The aim of this study is to investigate the perioperative temperature monitoring rates and the difficulties encountered during monitoring, particularly in patients undergoing neuraxial anesthesia.MethodsTwo hundred anesthesiologists were included in the study who work in Turkey and actively work in an operating room. A questionnaire was applied to the participants via printed form or e-mail.ResultsIn Turkey, the overall temperature monitoring ratio was measured as 5.5%. Temperature monitoring was the most frequently used for cardiovascular surgery patients group. In neuraxial anesthesia, temperature monitoring was only 1.5%. The most common reason for not using a temperature monitor was the lack of appropriate equipment (45%). The most common temperature monitoring area was the axillary zone (48%).ConclusionParticipants were aware of the importance of temperature monitoring but concluded that it was not sufficient in practice. Where and how to measure core temperature in awake patients is a controversial issue. Furthermore, the accuracy of measurements in neuraxial anesthesia should be discussed. Interestingly, raising awareness about this issue was not effective in the resolution of the problem. Still, in order to keep this issue up to date, the importance of perioperative temperature monitoring should be emphasized more frequently in anesthesia meetings and education programs.

Introduction Effective thermoregulatory care during neonatal transfer for surgical procedures is crucial in preventing inadvertent neonatal hypothermia. This narrative review thereby aims to investigate thermoregulation techniques used by paediatric theatre staff to prevent neonatal hypothermia during the neonate's surgical journey from theatres to Neonatal Intensive Care Unit (NICU). Key findings The review highlights the importance of continual temperature monitoring in ensuring prevention and diagnosis of hypothermia during intra hospital transfer. Additionally considerations for prevention of hypothermia in the theatre setting are identified including pre warming the theatre environment and equipment. The literature also identified that during intra hospital transfer of neonates following surgery there is a lack of specific guidelines relating to the exact combination of thermoregulation techniques required during such transfers. To prevent practices which are guided by theatre staff preference, findings suggest that guidelines are implemented that are clear, specific and standardised within surgical neonatal intra hospital transfer. Conclusions There is a lack of clinical guidelines pertaining specifically towards neonatal intra hospital transfer following neonatal surgery. Consequently, neonatal hypothermia has been reported post-transfer in research and the practice setting following transfers between Theatres to NICU. Thereby, further investigation of paediatric theatre staff neonatal thermoregulatory care is required along with the introduction of national standardised guidelines and paediatric theatre staff education to ensure evidence based practice.

According to the American Society of Anesthesiologists (ASA), basic anesthetic monitoring addresses a set of parameters (oxygenation, ventilation, circulation, and temperature) that should be continually evaluated. Among these, temperature monitoring might be the most neglected by medical staff, entailing various consequences that might be undervalued and not seen as directly correlated with poor patient outcome. This clinical case depicts a postoperative patient with a state of hypothermia and severe shivering, clinically and objectively registered, that could have led to disastrous consequences, highlighting the importance of normothermia throughout the perioperative period.

Endovenous laser ablation (EVLA) is a minimally invasive surgical procedure, often guided by ultrasound (US) imaging, for treating venous insufficiencies. US imaging limitations in accurately visualizing the catheter and the lack of a temperature monitoring system can lead to sub-optimal outcomes. An integrated photoacoustic (PA)-guided EVLA system has been previously developed and reported to overcome the shortcomings of US-guided procedure. In this study, we further characterized the system and tested the in vivo utility. In addition, PA thermometry was further explored by compensating the variation of PA signal with temperature with respect to the temperature-dependent absorption of blood and water. In vivo imaging results indicated that the PA-guided EVLA system can provide high contrast and accurate images of the ablation catheter tip overlaid on US images of the background tissue. Additionally, absorption-compensated PA signal amplitudes over a relevant range of temperature were measured and demonstrated.

The prevalence of diabetes in the United States and the world is high. Often the burden of this disease falls on those who are economically disadvantaged, contributing to disparities in access to care. Considering the risk for foot complications related to diabetes, foot temperature monitoring has been shown to be effective in mitigating risk for plantar ulceration. Higher-cost thermometers have been assessed for reliability, while very low-cost thermometers have not. Validation of low-cost thermometers could improve access to this preventive measure. In this study, inexpensive commercially available infrared thermometers were shown to be a reliable and valid means to assess local skin temperature.

Objective: To determine whether incorporating BEMPU TempWatch into the care of LBW/SGA neonates for continuous temperature monitoring decreases the rate of hypothermia requiring escalation of care. Methods: This was a randomised controlled trial conducted in a tertiary hospital in Melbourne, Australia. Participants were late preterm and term LBW/SGA neonates on the postnatal wards. Neonates were randomly assigned to receive either the BEMPU TempWatch in addition to standard care, or to receive standard care alone for the first 28 days of life. The primary outcome was hypothermia requiring escalation of care during initial hospital stay after birth. Results: Trial was discontinued after planned interim feasibility analysis, due to very low rates of hypothermia requiring escalation of care. In total, 75 neonates were included, with 36 in the intervention (TempWatch) group and 39 in the control group. The rate of hypothermia requiring escalation of care was 2/36 (5.6%) in the TempWatch group and 1/39 (2.6%) in the control group (relative risk (RR) 2.17, 95% CI 0.21 to 22.89). Rates of exclusive breastfeeding at discharge were 22/36 (61.1%) in the TempWatch and 13/39 (33.3%) in the control group (RR 1.83, 95% CI 1.10 to 3.07, p = 0.02). All other secondary outcomes were similar between the groups. Conclusions: Low rates of hypothermia requiring escalation of care in a tertiary, high-income setting meant it was not feasible for studying the effects of the TempWatch for this outcome. TempWatch may have a role in promoting exclusive breastfeeding, and this needs to be explored further.

Pressure ulcers (PU) are one of the most frequent hazards of long-term bedridden patients. With the continuous increase of aging, the number of long-term bedridden disabled and semi-disabled elderly people is increasing. At the same time, there is a serious shortage of professional pressure ulcer nursing staff. There is also a lack of flexible turning equipment for PU prevention. The research in the field of pressure ulcer prevention at home and abroad is carried out steadily, and the equipment for turning over by pneumatic or mechanical drive is developed. However, these devices often have insurmountable defects, such as complex structure, cost constraints, difficult control, weak body feeling, and so on. Under these circumstances, a set of pneumatic turnover mattresses based on clinical nursing methods have been developed. The mattress is divided into a turnover area and two support areas. The turnover airbag is linked with the support airbag to improve the patient’s comfort when passively turning over. The turnover amplitude and interval can be adjusted to provide a personalized turnover experience for bedridden patients. To improve the safety of the turning mattress during automatic turning, we also add a temperature sensor based on the principle of infrared reflection to monitor the status of bedridden patients, which can realize real-time temperature measurement, monitoring of getting out of bed and monitoring of the turning process.

The mud cake is easily formed during the tunnel boring machine (TBM) excavation in clay soils or rocks containing clay minerals. Mud cake will lead to soil disturbance of tunnel face, clogging cutterhead and even affect the construction efficiency and personnel safety. In this study, a discrimination method of mud cake formation based on cutterhead temperature was proposed. An online monitoring system was designed and installed on the slurry balance TBM. The results show that: (a) the cutterhead temperature data can be reliably detected and transmitted by the system; (b) in a tunneling cycle, the temperature at some positions of the cutterhead will increase first and then decrease; (c) during the field test, the temperature variation is around 2.5 °C under the normal condition, but the temperature variation will increase more than 50 °C due to the mud cake or geological change; (d) compared with the cooling rate, mud cake formation can be accurately discriminated.

Increases in climate extremes are predicted to occur with the progression of climate change, including higher temperatures in the form of heat waves and longer hotter summers; this means the bull will increasingly be exposed to conditions exceeding its thermoneutral zone. It is widely accepted that the scrotum evolved as a mechanism to allow testicular temperature to be maintained at lower temperature than that of core temperature and which is a requirement for normal spermatogenesis. Despite the wealth of research focused on the effect of elevated temperature on sperm quality, there is scant information regarding the efficacy of thermoregulation of the scrotum, especially continuous measurement over an extended period of time. The underlying question of this body of research was therefore how well can the bull maintain optimum scrotal temperature when subjected to high environmental heat load? In this thesis this question was explored with the advantage of continuous temperature monitoring of both body and scrotal temperatures and was the first study of its kind where these temperatures were measured over a period of months, where bulls remain conscious and unrestrained, and free to adopt natural behaviours.The hypotheses investigated in this thesis were:1) A surgically implantable device, either a data logger or radio transmitter, will be able to provide continuous temperature recording within the scrotal cavity whilst still allowing the bull to move freely.2) Implantation of a data logger into the bovine scrotal cavity does not impair thermoregulation and scrotal temperature returns to normal operation under thermoneutral conditions3) When bulls are exposed to simulated acute and chronic heat treatments, the thermoregulation of the scrotum is affected and there is a breakdown in scrotal thermoregulation manifested in increased scrotal temperature.4) By means of modelling, it is possible identify the primary variables that may influence scrotal temperature, including ambient temperature, relative humidity, temperature humidity index and body temperature.Bulls used in this study were surgically implanted with data loggers and radio transmitters that allowed for long-term temperature recording of both body and scrotal temperature. Infrared imaging was also investigated as an alternative option for temperature measurement. Bulls were subjected to two separate heat treatments with two replicates in a crossover experimental design. A shorter treatment of five days (acute heat stress) was designed to mimic a heat wave scenario whilst a longer treatment of 13 days (chronic heat stress) was used to simulate a long hot Queensland summer (based on long term conditions from Dalby; 21.1944°S, 151.2660°E). The key difference between the two treatments was the allowance for bulls to dissipate heat overnight during the chronic study due to a lower ambient temperature during nighttime hours.Key findings presented in this thesis included:Data loggers surgically implanted into the scrotum were suitable for long term continuous temperature recording with no evidence of parenchymal testicular histopathology. Radio transmitters, whilst successful in transmitting temperatures, experienced a large amount of data loss throughout. The use of infrared imaging to obtain repeated continuous temperature recordings without manipulating the position of the bulls proved to be unreliable.Post implantation, the scrotum takes less than 1 week to return to normal thermoregulation. During thermoneutral conditions and in a natural setting (i.e. Paddock), bulls are able to reliably maintain scrotal temperature below body temperature. There is variation between bulls in their baseline ST indicating that heat tolerance of the scrotum might be a selectable trait.During heat treatments, ST increases and changes from a steady continual temperature to a diurnal cycle indicating a possible breakdown in scrotal thermoregulation. High cross correlations (r > 0.9, P < 0.05) between ST and respiration rate (RR) suggested a possible connection between these two variables.There is potential to be able to model bovine ST based on a range of parameters including ambient temperature, relative humidity, and body temperature. ST models of bulls are exposed to heat stress conditions revealed that body temperature (BT) had the greatest impact on the strength of the fit of the models; this finding was absent when the bulls were examined under thermoneutral conditions.While there is much scope for the continuation of research investigating connections between scrotal temperature and responses by the bull, specifically in terms of refining the parameters that affect ST, this thesis provides a valuable starting point to understand the impact that heat load may have on scrotal thermoregulation. There is potential for this work to lead to additional phenotypic bull selection criteria to select breeding bulls with higher levels of heat tolerance.

Objective: to discuss in the scientific literature the strategies used to prevent hypothermia in newborns undergoing surgical procedures. Methods this is an integrative literature review, with structured search in April and May 2020 in 08 databases, using the descriptors: Hypothermia; Surgical Procedures, Operative; Infant, Newborn; Protocols. Four primary studies were selected and analyzed using three instruments to assess the methodological quality of the Joanna Briggs Institute and content analysis. Results: Among the strategies used, the following stand out: room temperature control; establishment of humidification and quality of air conditioning cleanliness; use of a heated incubator or cradle; use of thermal mattress; use of caps and blanket; heated fluids; temperature monitoring and abdominal organ coverage. Conclusion good hypothermia prevention strategies were identified, despite the small number of publications on this topic; thus, it points out the need for research with strong evidence. RESUMEN Objetivo: discutir, en la literatura científica, las estrategias utilizadas para prevenir la hipotermia en recién nacidos sometidos a procedimientos quirúrgicos. Métodos: revisión integrativa de la literatura, con búsqueda estructurada en abril y mayo de 2020 en 08 bases de datos, utilizando los descriptores: Hypothermia; Surgical Procedures, Operative; Infant, Newborn; Protocols. Se seleccionaron y analizaron cuatro estudios primarios utilizando tres instrumentos para evaluar la calidad metodológica del Instituto Joanna Briggs y el análisis de contenido. Resultados: entre las estrategias empleadas destacan: control de la temperatura ambiente; establecimiento de humidificación y calidad de aire acondicionado limpio; uso de una incubadora o cuna con calefacción; uso de colchón térmico; uso de gorros y mantas; fluidos calentados; monitoreo de temperatura; cobertura de órganos abdominales. Conclusión: se identificaron buenas estrategias de prevención de la hipotermia, a pesar del escaso número de publicaciones sobre este tema; por lo tanto, señala la necesidad de realizar investigaciones con evidencia sólida. RESUMO Objetivo: discutir, na literatura científica, as estratégias utilizadas para prevenção de hipotermia em recém-nascido submetido a procedimentos cirúrgicos. Métodos: revisão integrativa de literatura, com busca estruturada em abril e maio de 2020 em 08 bases de dados, utilizando os descritores: Hypothermia; Surgical Procedures, Operative; Infant, Newborn; Protocols. Foram selecionados e analisados 04 estudos primários por meio de três instrumentos para avaliação da qualidade metodológica da Joanna Briggs Institute e da análise de conteúdo. Resultados: dentre as estratégias utilizadas destaca-se: controle da temperatura ambiente; estabelecimento de umidificação e qualidade de limpeza do ar condicionado; utilização de incubadora ou berço aquecido; uso de colchão térmico; uso de toucas e cobertor; fluidos aquecidos; monitoramento da temperatura; cobertura de órgãos abdominais. Conclusão: identificaram-se boas estratégias de prevenção de hipotermia, apesar de haver um número reduzido de publicações nesta temática; dessa forma, aponta-se a necessidade de pesquisas com evidências fortes.

Introduction:Accurate temperature monitoring of neonates is vital due to the significant morbidities and mortality associated with neonatal hypothermia. Many studies have compared different thermometers in neonates, however, there is a lack of consensus regarding which of the currently available thermometers is most suitable for use in neonates.Objectives:The aim of this review was to identify and compare current methods available for temperature monitoring of neonates beyond the delivery room, including the accuracy, advantages and disadvantages of each.Methods:A recent search and narrative synthesis of relevant studies published between January 1, 1949 and May 5, 2021 on the OVID Medline, PubMed and Google Scholar databases.Results:A total of 160 papers were retrieved for narrative synthesis. The main methods available for temperature monitoring in neonates are human touch and mercury-in-glass, electronic, infrared tympanic and other infrared thermometers. Newer innovations that are also available include liquid crystal thermometers and the BEMPU TempWatch. This paper discusses the current evidence available regarding the utility of these devices, and identifies barriers to valid comparison of different thermometry methods.Conclusion:Many methods for temperature monitoring in neonates are currently available, each with their own advantages and disadvantages. However, the accuracies of different devices are hard to determine due to variable methodologies used in relevant studies and hence, further research that addresses these gaps is needed.

Traumatic Brain Injury (TBI) patients more often than not develop fever within the first few days of their hospitalization. Studies report that causes are variable and according to the pathogenesis, fever may be harmful or protective. The study was conducted to correlate the development of fever with clinical prognosis. Throughout the study spanning 6 months, a total of 98 patients of TBI were included. In the first 48 hours, 54 patients did not develop fever (temperature >37?), 20 patients recorded temperatures between 37? and 39?; and 24 patients developed high fever (39?). On regular temperature monitoring and follow up, it was found that patients developing fever relatively early during hospitalization were more likely to end up with a poor outcome (Glasgow outcome scale 4 to 5). Therefore, fever is independently a predictor of poor prognosis in TBI patients and should be managed diligently in the first few days.

Temperature monitoring of the brain using radiothermometric technology allows you to assess the imbalance of the thermal balance of the brain, and the technique has shown the possibility and information content of its use in the diagnosis of cerebral lesions. In healthy individuals, at rest, the average temperature of the left (36.74 ± 0.37 ° C) and the right hemisphere (36.64 ± 0.32 ° C). In boxing athletes who received "planned" minor traumatic brain injuries after training sparring, the average temperature of the left (38.4 ± 0.28 ° C) and right temperature (38.2 ± 0.45 ° C), which is significantly elevated. Patients in chronic critical conditions showed a monotonous temperature distribution in the left (36.98 ± 0.18 ° C) and right hemispheres (36.88 ± 0.21 ° C). The temperature heterogeneity of the brain in this category of patients was less pronounced compared with healthy individuals, athletes after sports head injury.

In the paper a method of temperature monitoring for high frequency welding of soft tissues is presented. The method enables to investigate the distribution of temperature fields in biological tissues. This allows to assess the influence of the skin effect on current passage in a process of electrosurgical interventions.The present paper describes an investigation of distribution of temperature fields in biological tissues affected by electrosurgery upon use of an infrared thermograph. In the experiment, the dynamics of temperature distribution in the tissue was registered upon using thermal imaging cameras FLIR i7. Ablation of the tissues by HF current was performed with ЕКВЗ-300 unit (E.O. Paton Electric Welding Institute). Most important result of application of the method of temperature monitoring is an establishment of the moment for removal of the electrodes that ensures an avoidance of carbonization of the cardiac tissues during their ablation

Background Monitoring of temperature changes and accurately determining the moment of electrode removal during open heart operations is not well recognized. Objective We investigated the temperature fields distribution in the biological tissues affected by electrosurgery upon use of an infrared thermograph. Methods The dynamics of temperature distribution in the tissue was registered by the thermal imaging camera FLIR i7. Measurement of the temperature between electrode couples was carried out for two operation modes: coagulation (100% power) and coagulation (50% power). Results The most important result of the applied method of temperature monitoring is a determination of the moment for electrodes removal that ensures the avoidance of carbonization of the cardiac tissues during their ablation. Conclusions Temperature monitoring for connection of soft live biological tissues by welding allows the power to be fed in the amount sufficient for a formation of continuous ablation of the myocardium tissue.

Mastitis commonly occurs in dairy cattle during lactation. This disease has huge effects on the productivity of dairy cattle and the profits of stock farms. Enhancing the efficiency of mastitis treatment begins with the early detection of the disease. The purpose of this research is early detection of mastitis by monitoring the pathogenesis of mastitis through real-time measurements of the rumen temperature by utilizing an ingestible bio-sensor. The ingestible bio-sensor used for this research is orally administered and settles in the rumen. This bio-sensor can measure the cattle's body temperature accurately without any interference from the ambient environment. Also, this method requires less labor and the cattle experience less stress. The measured body temperature data is collected and transmitted to a server for analysis to detect any abnormalities. We administered bio-sensors to 50 Holstein dairy cattle and monitored their rumen temperatures for six months by measuring the temperatures in 10-min intervals. The farm manager could receive mastitis alert messages through a mobile application when a rise in a cow’s body temperature was detected. In addition, the manager conducted daily CMT to diagnose any mastitis incidence. The study results showed 15 subclinical mastitis incidences including recurrences from 9 cows, with 14 alert messages sent from the body temperature monitoring system. The average temperature of high fever cases was 41.10 °C. And the temperature difference between the average temperature of the experimental animals and the highest temperature of mastitis afflicted animals was on average 2.42 °C which shows that mastitis is accompanied with a high rise in body temperature.

Inadvertent perioperative hypothermia is a widely known patient condition that is associated with postoperative complications. This retrospective comparative study of 298 surgical patients was conducted at a single hospital site in the midwestern United States. Our aims were to describe risk factors and outcomes associated with perioperative hypothermia. We compared the type and frequency of patient factors, clinical factors, and postoperative complications during the inpatient stay of the sample patients to determine whether there were factors or complications associated with perioperative hypothermia. Significant factors associated with the occurrence of perioperative hypothermia included older age and type of surgery. Hypothermia in patients was associated with a higher rate of postoperative complications when compared with normothermic patients. Nurses and perioperative leaders should understand the risk factors and complications associated with perioperative hypothermia to collaboratively develop and test evidence-based initiatives, improve care, and promote optimal patient outcomes.

Pre-hospital transfusion of blood products is a vital component of many advanced pre-hospital systems. Portable fluid warmers may be utilised to help prevent hypothermia, but the limits defined by manufacturers often do not reflect their clinical use. The primary aim of this randomised in-vitro study was to assess the warming performance of four portable blood warming devices (Thermal Angel, Hypotherm X LG, °M Warmer, Buddy Lite) against control at different clinically-relevant flow rates. The secondary aim was to assess haemolysis rates between devices at different flow rates. We assessed each of the four devices and the control, at flow rates of 50 ml.min-1 , 100 ml.min-1 and 200 ml.min-1 , using a controlled perfusion circuit with multisite temperature monitoring. Free haemoglobin concentration, a marker of haemolysis, was measured at multiple points during each initial study run with spectrophotometry. At all flow rates, the four devices provided superior warming performance compared with the control (p < 0.001). Only the °M Warmer provided a substantial change in temperature at all flow rates (mean (95%CI) temperature change of 21.1 (19.8-22.4) °C, 20.4 (19.1-21.8) °C and 19.4 (17.7-21.1) °C at 50 ml.min-1 , 100 ml.min-1 and 200 ml.min-1 , respectively). There was no association between warming and haemolysis with any device (p = 0.949) or flow rate (p = 0.169). Practical issues, which may be relevant to clinical use, also emerged during testing. Our results suggest that there were significant differences in the performance of portable blood warming devices used at flow rates encountered in clinical practice.

BACKGROUND AND OBJECTIVES The 30-min rule has been used to maintain a core temperature (CT) of red-blood-cell (RBC) units below 10°C during transportation. We evaluated the utility of temperature-sensitive indicators (TIs) to monitor the surface temperature (ST) of RBC units and to explore whether TIs can help with compliance with the 30-min rule by extrapolating or correlating temperature change with time. MATERIALS AND METHODS Two US FDA-approved TIs, Safe-T-Vue 10 (STV10; Temptime Corporation, Morris Plains, NJ, USA) and Timestrip Blood Temp 10 (BT10; Timestrip UK Ltd, Cambridge, UK), were attached to 50 RBC units. After issue, their colour change indicating 10°C was monitored, and temperature excursions were measured by standard reading. In additional 18 RBC units, both ST and CT were monitored simultaneously. RESULTS In 50 RBC units, 94% of STV10 and 100% of BT10 showed colour change indicating 10°C within 30 min; 4% of STV10 and 18% of BT10 showed it during transportation. The time for colour change indicating 10°C differed significantly between STV10 and BT10 (19·0 vs. 5·6 min, P

OBJECTIVES: To assess the community pharmacy practices in Timergara City in view of the standards set by the Drug Regulatory Authorities of Pakistan (DRAP). METHODOLOGY: A cross-sectional survey of community pharmacies, Timergara city, was conducted from 2nd October to 28th November 2016. Out of 155 community pharmacies 149 community pharmacies participated in the study. The data was collected on structured questionnaire. Face to face interview technique was used for data collection. RESULTS: Among these pharmacies only 02 (01%) dispensers were qualified pharmacist with a Pharm-D degree, 08 (05%) had B-Pharm degree, 80 (54%) had diploma in pharmacy and 59 (40%) had passed the pharmacy examination. Majority of community pharmacies 141 (95%) were selling medicines without prescription. In 140 (94%) of pharmacies, there were no arrangements for the control of insects, rodents and birds to prevent and eliminate possible infestation. In 140 (94%) pharmacies the medicines were stored on the floor, stairs and passageways due to lack of space. Only one pharmacy had temperature monitoring device and 19 (13%) pharmacies had refrigerators. Majority of the pharmacies 113 (76%) were using register for keeping record of the sale and purchase medicines. In 128 (86%) pharmacies the entrance was not accessible to the peoples with physical disabilities. CONCLUSION: The community pharmacy practices in Timergara City was ineffectual with inexperienced staff, lack of prescription and security, and medicines were not stored according to the Drug Regulatory Authorities of Pakistan.

Background: Hypothermia occurs in up to 20% of perioperative patients. Systematic postoperative temperature monitoring is not a standard of care in Brazil and there are few publications about temperature recovery in the postoperative care unit. Design and setting: Multicenter, observational, cross-sectional study, at Hospital de Base do Distrito Federal and Hospital Materno Infantil de Brasília. Methods: At admission and discharge from postoperative care unit, patients undergoing elective or urgent surgical procedures were evaluated according to tympanic temperature, vital signs, perioperative adverse events, and length of stay in postoperative care unit and length of hospital stay. Results: 78 patients, from 18 to 85 years old, were assessed. The incidence of temperatures

Purpose: To estimate effectiveness and safety of innovative dressings in local conservative therapy of children with burns.Materials and methods: the study was based on the results of using innovative dressings in children aged 1–4 years with I–II–III degree skin burns occupying 1–10% of body surface (b. s.). Routine methods of examination such as follow-up visual examination of wounds, temperature monitoring, follow-up microbiological control of burn wounds determining sensitivity to antimicrobials were used; duration of spontaneous epithelization of the burnt areas, lack or availability of allergic and other adverse reactions were determined.Results and conclusions: effectiveness and safety of using therapeutic dressings in patients with thermal injuries are verifed using clinical cases. Good therapeutic effect is confrmed when a line of dressings is combined depending on the phase of the wound process and tissue affection depth with hot liquid. Possible complications in the form of allergic reactions are found (contact dermatitis, in particular). Methods of their prevention or adequate local conservative therapy are recommended. Results of using LikoTul Ag+, PoviTex, JelleSorb Ag + Tube and AquaColl Ag+ dressings display their effectiveness and safety.

Objective: Continuous temperature monitoring in high-risk patients can enable healthcare providers to remotely track patients’ temperatures, promptly detect fevers and timely intervene to improve clinical outcomes. We evaluated if a novel wearable, continuous temperature monitor (Verily Patch) can reliably estimate body temperature and early detect fevers in an outpatient setting in patients at a high risk of febrile neutropenia (FN) who recently underwent chemotherapy and autologous stem cell transplantation (ASCT). Methods: 86 patients at a high risk for FN were prospectively enrolled at Mayo Clinic, MN. Patients wore the device in their axilla region for 7 days post ASCT and recorded self-measured oral temperatures every 3 hours. Patients were also followed using clinical standard-of-care procedures with daily oral temperature assessment. The clinic- and patient-assessed oral temperatures were used to develop and evaluate Verily Patch’s body temperature and early fever detection algorithms using a K-fold cross-validation approach. Results: The Verily Patch reliably measured body temperatures with an error of 0.35 ± 0.88°F in comparison to clinic- and patient-assessed oral temperatures. The sensitivity and specificity of the patch in detecting clinic-assessed fever episodes was 90.2% and 87.8%. The patch detected 14.3 times the number of clinic-assessed fever episodes with a median lead time of 4.3 hours. Conclusion: Patient self-monitoring of temperature and fever incidents suffers from low accuracy and is impractical for extended periods of time. Continuous temperature monitoring by a wearable device (such as Verily Patch) has the potential to overcome these challenges resulting in better patient clinical outcomes and more cost-effective care.

Background Target temperature management (TTM) is suggested to reduce brain damage in the presence of global or local ischemia. Prompt TTM application may help to improve outcomes, but it is often hindered by technical problems, mainly related to the portability of cooling devices and temperature monitoring systems. Tympanic temperature (TTy) measurement may represent a practical, non-invasive approach for core temperature monitoring in emergency settings, but its accuracy under different TTM protocols is poorly characterized. The present scoping review aimed to collect the available evidence about TTy monitoring in TTM to describe the technique diffusion in various TTM contexts and its accuracy in comparison with other body sites under different cooling protocols and clinical conditions. Methods The scoping review was conducted following the guidelines of the Preferred Reporting Items for Systematic Review and Meta-Analysis extension for scoping reviews (PRISMA-ScR). PubMed, Scopus, and Web of Science electronic databases were systematically searched to identify studies conducted in the last 20 years, where TTy was measured in TTM context with specific focus on pre-hospital or in-hospital emergency settings. Results The systematic search identified 35 studies, 12 performing TTy measurements during TTM in healthy subjects, 17 in patients with acute cardiovascular events, and 6 in patients with acute neurological diseases. The studies showed that TTy was able to track temperature changes induced by either local or whole-body cooling approaches in both pre-hospital and in-hospital settings. Direct comparisons to other core temperature measurements from other body sites were available in 22 studies, which showed a faster and larger change of TTy upon TTM compared to other core temperature measurements. Direct brain temperature measurements were available only in 3 studies and showed a good correlation between TTy and brain temperature, although TTy displayed a tendency to overestimate cooling effects compared to brain temperature. Conclusions TTy was capable to track temperature changes under a variety of TTM protocols and clinical conditions in both pre-hospital and in-hospital settings. Due to the heterogeneity and paucity of comparative temperature data, future studies are needed to fully elucidate the advantages of TTy in emergency settings and its capability to track brain temperature.

Aim: To achieve the National Neonatal Audit Programme (NNAP) standard of 90% normothermia among preterm infants born under 30 weeks of gestation. Methods: Project SHIP (Stopping Hypothermia In Premmies) was a quality improvement programme to improve admission normothermia. Phase 1 of the project implemented low-fidelity simulations during 2011–2016. In Phase 2 (2017), a multimodal approach to quality improvement was used, including in situ simulations, videos of simulated scenarios, an allocated team member for thermal care, a clear protocol for thermal care, a coordinating ‘lollipop man’ role and monthly performance feedback. Additionally, continuous temperature monitoring using servo-control during stabilisation was introduced during Phase 2. Phase 3 (2018–2019) focused on embedding practice and maintaining performance. Results: Phase 1 initiatives resulted in improvement of normothermia rates from 58% to 75%. However, the results plateaued. During Phase 2, the hypothermia rate fell from 16% to 3%. During Phase 3, this improvement in the hypothermia rate was sustained, achieving the standard of 90% normothermia in 2018 and falling just short in 2019 due to an increased hyperthermia rate. Conclusion: A multimodal quality improvement approach achieved sustained improvement in normothermia. Continuous temperature monitoring during stabilisation allows resuscitating teams to plan interventions to treat hypothermia and hyperthermia.