Chart 8.—Temperature chart showing sudden elevation of temperature, coincident with the marked loss of weight, in inanition fever.
The baby should be lightly clad; should be kept quiet and in a cool, shady place out-of-doors as much as possible. During the warmest part of the day, however, he will often be much better off and more comfortable in the house, in a room with the shutters closed. But while keeping the baby cool, the nurse must bear in mind the harm that will be done by chilling him or exposing him to a cold draft or wind. Several tub baths, daily, are often given, at a temperature of 100° F., rather than cool sponge baths because of the baby’s feebleness and inability to react to cool bathing. Packs are also employed, both for high temperature and restlessness and may be cool (80° F.), tepid (100° F.) or hot (105° F. to 108° F.) according to the doctor’s orders; intestinal irrigations; lavage and gavage.
Fig. 177.—Putting the baby in a wet pack.
To give a pack, the nurse will cover the bed with a rubber and sheet and bring to the bedside a basin containing a sheet wrung from water of the specified temperature; a basin containing ice and compresses for the baby’s head, and a flannel covered hot-water bottle at 120° F., for his feet. The baby is laid on the upper half of the folded wet sheet, and an upper corner wrapped about each arm (Fig. [177]), and the sides folded around his legs. The lower half is brought up between his feet to cover his entire body and tuck around his shoulders. The hot-water bottle is placed at his feet and an ice compress on his head. (Fig. [178].) If the sheets are wrung from warm or hot water, the baby is covered with a blanket after he is put into the pack.
Fig. 178.—Baby in pack with hot-water bag at feet and cold compress on head. (Figs. [177] and [178] from photographs taken at Johns Hopkins Hospital.)
Fig. 179.—Diagrams showing successive steps in putting baby in pack shown in Figs. [177] and [178].
Intestinal irrigations, of normal salt solution are often given to babies suffering from intestinal disorders, sometimes once or twice daily to wash out the lower bowel, or a cool irrigation may be given to reduce temperature, the amounts varying from ½ to 2 gallons of solution. The baby should be placed on a pillow and rest on a bed-pan, being protected from chilling as for, an enema (See Fig. [186]), and provision made for a two-way flow of the fluid. A small catheter attached by means of a connecting glass nozzle to the tubing on the irrigation bag may be passed into a slightly larger catheter, which is inserted into the rectum about six inches, the fluid flowing in through the small inner tube and out through the larger one which encases it. Or a small catheter for the outflow may be inserted in the rectum alongside the one through which the solution is introduced. Normal salt solution, glucose or bicarbonate of sodium solution are sometimes given by the drip method at the rate of 20 to 40 drops per minute. In this case a glass tube is introduced at some point in the rubber tubing in order that the rate of flow may be watched and regulated by means of a clamp or a stop-cock. The catheter is inserted in the rectum about six inches and held in place by strips of adhesive plaster.