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Time = Brain

Time=Brain is a regional Neonatal Therapeutic Hypothermia project devised and led by Dr. Peter Reynolds and supported by South East Coast Neonatal Network and the Maternity, Children & Young People’s Strategic Clinical Network


The South East Coast (SEC) Time=Brain project aims to enhance the protection of babies' brains when there is evidence of moderate or severe encephalopathy through optimising the use of therapeutic hypothermia (cooling).

There are four key aims to this project:

  1. To ensure that the decision to cool babies is consistently applied across the SEC region
  2. To achieve the target temperature range safely & promptly, avoiding under- or over- cooling
  3. To achieve the target temperature (33-34°C) within 6 hours of birth (or postnatal collapse event)
  4. To maintain the target temperature during handover and transport of babies

The key message for Time=Brain is that there is sufficient time to examine and document the baby's neurology, diagnose the Grade of Encephalopathy and start servo-controlled cooling for moderate and severe grades, to reach the target temperature within 6 hours of birth according to NICE Guidelines.



Email Form Use this form to submit data by email or post - it is the simplest option but MUST be fully completed (e.g. scores must not be left blank or labelled N/A!)



Clinical Documents

Grading of Neonatal Encephalopathy - clinical indicators to guide early diagnosis. Mild NE symptoms should be mild and few (i.e. multiple symptoms may be moderate NE) and improving hourly, if uncertain discuss with NICU consultant early on.

Decision making pathway This is the pathway to help clinicians decide on whether to initiate cooling and to document discussions with NICU Consultants. A diagnosis of moderate to severe NE should be suspected.

Please use the email/print form above for the key data

Clinical Prompts Useful clinical prompts when managing cooled babies for ventilation, blood pressure, fluids etc. Please discuss with Consultant.

Birth Code - simple spreadsheet to preserve patient details confidentiality. Keep a record of the details securely within your hospital IT systems, but use the patient code in the documentation for Time=Brain

Background information and evidence The published evidence to date which has been used to prepare the Time=Brain project

How to complete documentation Where to send completed data/pathway information



Training Presentation

Time=Brain v1.9 (PowerPoint 2010 onwards)

Time=Brain v1.9 (PowerPoint 2003)



Parent InformationParent Information Leaflet This leaflet for parents explains about HIE and cooling treatment. It is designed to be printed out in colour (landscape, double-sided, flip on short edge)



NICU and Transport ContactsContact details Contact details for SEC NICU, Transport Teams and EBS



Nursing DocumentsNursing Documentation

Nursing Competency Document for Cooling using Tecotherm NEO Nursing competency for Time=Brain, for delivering nursing care for a baby undergoing therapeutic hypothermia



PostersPoster for wards This poster is for Delivery Suite, Neonatal and Postnatal Ward Staff



Technical DocumentsTechnical Documents

Tecotherm NEO TN300 Instructions v15

Tecotherm NEO TN300 Instructions v1

Tecotherm NEO TN300 Fallback mode explained v5




Dr. Peter Reynolds 2016