New update on NICE guideline

The National Institute for Health and Care Excellence (NICE) in the United Kingdom provides national guidance and advice to improve health and social care. NICE guidance is comprised of evidence-based recommendations developed by independent committees, including professionals and lay members, and consulted by stakeholders.


In March 2021, NICE guidance has published new updates on the guideline for caesarean birth. The new updates included and highlighted on the prevention and management of hypothermia and shivering. See the new sections added below.


  • Warm IV fluids (500 ml or more) and blood products used during caesarean birth to 37 degrees Celsius using a fluid warming device.


  • Warm all irrigation fluids used during caesarean birth to 38 to 40 degrees Celsius in a thermostatically controlled cabinet.


The committee recommended the use of warmed IV fluids and irrigation fluids for all women having caesarean birth. They found evidence for the effectiveness of active warming measures (for example, forced-air warming, under body pads, warmed IV fluids) to prevent shivering and hypothermia in women having a caesarean birth, and there was some evidence for improved thermal comfort and maternal temperature.


On the official website of NICE, you can find an explanation of why the committee made these recommendations and how they might affect practice and see the rationale and impact section on prevention and management of hypothermia and shivering. Moreover, full details of the evidence and the committee’s discussion are available in evidence review C: prevention and management of hypothermia and shivering.



The ˚M Warmer System

The ˚M Warmer is a portable blood and IV fluid warming device optimal for both prehospital and hospital use as it is small, simple to use and has extremely efficient warming capabilities (150 ml/min).