Author: Edie Patterson, BSN, RN, CNOR
Category: Outpatient Surgery
ONE STEP UP Forced-air warming is often the preferred choice in preventing unintentional hypothermia.
In an effort to standardize how we warm patients, we tested 3 warming options on more than 800 patients at our hospital-affiliated surgery center: forced air, heat reflective technology and warmed cotton blankets. Rather than let our anesthesia providers decide which method was the most effective and economical choice to prevent hypothermia, we wanted to put the warming methods to the test. The results might surprise you.
Our center hosts a wide range of major and minor procedures that last from 15 minutes to 8-plus hours. Our warming policy was whatever the anesthetist prefers. Determining if any method outperformed the others would help standardize the process and could potentially save on case costs if we could forgo the use of forced-air blankets or heat reflective technology in favor of warmed cotton blankets.
During the study period, we assigned patients in pre-op bays 1, 3 and 5 to receive warming with heat reflective technology and patients in bays 2, 4 and 6 to receive warmed cotton blankets for shorter-duration procedures or forced-air warming for procedures expected to last longer than 1 hour.
We recorded temporal artery temperature readings every 30 minutes in pre-op, every 30 minutes in the OR after anesthesia induction and every 30 minutes in PACU until normothermia was maintained for an hour. We set the ambient temperature in the ORs between 69°F and 72°F, as recommended by AORN, and conducted daily checks in the ORs and in each pre- and post-op patient bay to ensure temperatures stayed within the recommended range.
Temperature readings from at least one phase of care were missing for 242 patients, so they weren’t included in the final results, which showed that of the remaining 595 patients, 549 (92%) maintained normothermia and 46 (8%) experienced a hypothermic event. Our findings fell within the reported 4% to 9% range of patients who typically experience hypothermia. I expected our rate would be less, because some of our minor procedures are over in minutes.