This tool is intended to promote identification and early referral of babies at risk for hypoxic ischemic encephalopathy (HIE). It does not determine if a baby should be cooled. The decision to proceed with cooling should only be made after consultation with a Regional Cooling Center (ref. CCS numbered letter), based upon their institutional criteria. These recommendations are based on the HIE early screening toolkit published by the California Perinatal Quality Care Collaborative (CPQCC)
Gestational Age >= 35wks *
Yes No unknown
Age in Hours *
Acute Perinatal Events
Apgar @10min
Worst Cord Blood Gas
Infant Blood Gas within 1hr of life
Continued need for assisted ventilation at 10 mins of life.
Yes No unknown
  • If directed to cool, see protocols: