In this section
Definition of terms
Preparation of the Techniice sheets
Disposing of the Techniice
Family Centred Care
The importance for bereaved families to be
offered the opportunity to spend time with their child after death, in hospital
and at home, is well described in literature. Previously the hurdles of environmental
needs to maintain the integrity of the child’s body have limited the
opportunity to provide this extended service to families of children older than
one. Information on the other cooling options, such as Very Special Kids, which
offers a Cool Room, and the use of the Cuddle Cot, a cooling mattress that can
fit an infant, can be found on the Death of a Child CPG.
Techniice is a portable, disposable, cooling
system that allows any family who wish to spend extended time with their child
The aim of this guideline is to provide nursing,
allied health and medical staff with an overview of the use and management of
Techniice during after death care at the Royal Children’s Hospital, Melbourne.
Techniice is a single use disposable sheet made
of high-density plastic and refrigerant polymer which is non-toxic. The thin
flat sheets can be hydrated with water through a one-way perforation technology
that allows water to be absorbed but not leak out. Once frozen the refrigerant
polymer will maintain temperatures under –18oC, which means when rotating the
product as needed, it can be used to keep a body cool for several days post
death, allowing time for a family to spend time with their baby, child or teen.
Techniice is suitable for consideration:
The benefit of Techniice:
involves two steps: hydration and freezing.
Consider the size
of the child you are making the Techniice for prior to hydrating the sheets.
Each Techniice sheet comes with 24 cells. In the case of a smaller neonate, or
smaller sections of the child (such as under the neck) it is best to cut the
sheets into the required size prior to hydrating them.
Below are the
recommended number of sheets needed (they do not need to be cut into individual
If expecting to
keep the body cool for several days, prepare and freeze double the number of
sheets required to allow for rotation as needed.
It is safe to
hydrate and freeze several precut sizes, to ensure some appropriately sized
sheets are always available. The purpose bought freezer located in the RCH Body
Hold will always have the following available:
as dehydrated sheets which must be fully submerged into water prior to
video on this following process above can be found here (How to Hydrate Techniice Dry Ice Packs
You will need:
Techniice sheets, access to water, sink or bath and large dry towel
Image 1: Prior and after hydration (curtesy of
to be placed into the freezer flat with plastic side down. Separate sheets with
a provided reusable silicone mat between each sheet to ensure the sheets do not
stick to each other. Do not use cling wrap between sheets as these will stick
to the sheets as they freeze and compromise the integrity of the product.
remain in the freezer for a minimum of 24 hours for best results.
Once frozen they
are ready for use.
It is important
to talk through the purpose of the Techniice with the family in a sensitive
manner. The coolness of the sheets and subsequent cooling of the child can be
distressing to family if they have not had the purpose of its use explained.
is placed to assist cooling as soon after death as appropriate. It is not
compulsory but, in the circumstance, where it is expected that a child will not
be transferred to the mortuary or picked up within 4 hours post death the use
of Techniice will optimise the integrity of the body.
Techniice should not be placed directly to or under the body as it will damage
the skin. It must be placed in a single thickness sheet (this can be either a
hospital sheet or the family's own linen.
It is only required
with initial cooling to place Techniice ice:
The other key
locations that should always have Techniice are:
Suggested sheet placement on an older child courtesy of Queensland Health
Each sheet will
commonly last at least 8-10 hours, though may need replacing earlier if noted
to be warming up (they will feel soft and warm to touch). Environmental
factors, such as cuddling, or the ambience of the room may hasten defrosting of
the cells. In this case, the sheets may be rotated earlier.
When rotating the
Techniice sheets, remove the prefrozen second set from the freezer, lift the
child, or roll the child gently to their side and replace the defrosted sheets
with the new frozen replacements, ensuring they are not placed directly onto
In the hospital
setting the previous sheets must be discarded – do not place them back in the
freezer, even if the intent is for the same patient. In the home setting the
family may place them back in their home freezer to re-freeze. There is no need
to repeat the hydration steps, the family can simply wipe the sheets down with
a dry tea towel/cloth and place back in the freezer. Continue to rotate the
sheets until after death care is no longer required (I.e the child is placed in
the mortuary or collected by a funeral director).
The contents of Techniice are
non-toxic and safe to dispose in the normal waste in hospital and the household
waste bin in a community setting, the product itself is designed to breakdown
after long exposure to UV light. Techniice also offers a free recycling service
at their Frankston outlet. In the circumstance where the child is under contact
precautions, such as cytotoxic or droplet infection control, and there is
concern the sheets have had contact with the child, then the product should be
discarded in a provided hazardous or cytotoxic waste bin.
Please note in
the Death Checklist, under subtitle: Destination of Body, if the product has
Death of a Child
Use of Bereavement
Facilities Policy and Procedure
Special thanks to Paediatric Palliative Care
Service, Queensland for their advice and support in the development of this
The evidence table for this guideline can be accessed here.
Please remember to read the disclaimer.
of this nursing guideline was coordinated by Melissa Heywood, CNC, Victorian
Paediatric Palliative Care Program, Jess Rowe, RN, Rosella, and Gemma Sutton,
RN, Butterfly, and approved by the Nursing Clinical Effectiveness Committee. First published June 2022.