It is mostly a common sense that inadvertent hypothermia during surgical procedures can cause excessive bleeding, wound infections, reduced medication metabolism and potentially fatal arrhythmias. The whole surgical team needs to use effective methods of pre, intra, and postoperative patient warming that reduce the threat of hypothermia.
Preoperative Warming Considerations
Patient warming in the preoperative holding area is a positive first step in maintaining patient normothermia. The majority of heat loss in a patient occurs from exposed body surfaces. The application of a single heated cotton blanket is known to reduce heat loss by 33 percent. Increased skin temperatures from warmed blankets help with pre-surgical vasodilation, which aids in easier IV access.
The heat-transfer process begins immediately when the blanket is removed from the warmer as the warmed blanket loses heat to the ambient air. Because the warmed blanket will cool before it reaches the patient, the blanket should be as warm as possible in the warmer.
Intraoperative Warming Considerations
The greatest contributing factors to inadvertent hypothermia during surgical procedures is exposure to cooler temperatures within the OR environment and the application of anesthesia that compromises the body's ability to generate heat. The American Society of PeriAnesthesia Nurses (ASPAN) recommends skin exposure be limited with the use of warm blankets, socks and head coverings and ambient room temperatures should be increased to between 20 and 23˚ C (68 and 73˚ F). Several studies using warmed intravenous fluids at 42˚ C (108˚ F) have been shown to maintain the patient's core temperature throughout the procedure.¹
The Association of periOperative Registered Nurses (AORN) and the Centers for Disease Control and Prevention (CDC) agree that systemic warming has a significant effect on reducing the rate of wound infections. Fluid warming is a low-maintenance, no-risk intervention that should be considered for all patients.
Postoperative Warming Considerations
Continuing blanket warming and intravenous fluid warming methods into recovery and PACU increase positive patient outcomes.
