Archive Infection Control 2019

A Proactive Approach To Preventing Hypothermia

Pre-warming was the difference-maker in our quest to maintain normothermia in patients from pre-op to PACU.

Amy Yarbrough

Amy Yarbrough, BS, BSN, RN, CNOR

BIO

HOT TAKE
Pamela Bevelhymer, RN, BSN, CNOR
HOT TAKE Begin active warming in pre-op and continue it in the OR to prevent the significant initial temperature drop that redistribution hypothermia causes.

Patients who wait nervously for surgery in skimpy gowns always appreciate the effort you make to keep them warm and comfortable. They'd appreciate it even more if they knew inadvertent perioperative hypothermia has been linked to increased risk of wound infection, blood clotting disorders and cardiac events.

With those adverse events in mind, we reviewed a series of case records in our facility's electronic medical record to see how many patients were hypothermic (body temperature below 36°C) in the OR and in PACU. We focused on cases expected to last longer than 2 hours and those that leave large areas of skin surface exposed: open abdominal procedures, lateral hip revisions and anterior/posterior spinal fusions.

The chart review revealed we had a patient warming problem. It was most apparent in the OR, where 71% of initial and 46% of final temperature readings were below 36°C. The results were better in the PACU, where 11% of initial temperature readings didn't reach the target temperature for normothermia. Still, there was room for improvement in how well we warmed recovering patients.

We had identified the issue, but how could we fix it? Our first step was to take a closer look at our warming practices to determine how we could continue keeping patients comfortable during their stay and, more importantly, protect them from harm.

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