Archive January 2014 XV, No. 1

How Do You Warm Your Patients?

There are many ways to prevent hypothermia.

Dan O

Dan O'Connor, Editor-in-Chief


patient warming TAKE THE TIME Perioperative hypothermia is associated with poor outcomes for patients, yet it's preventable in most cases.

The evidence is overwhelming: Patients that are warm have far better surgical outcomes than those that aren't. They have fewer infections, faster emergence from anesthesia, better comfort and shorter stays in recovery. Warm patients are also more satisfied, so thrilled that they didn't shiver through surgery that they'll write you a thank-you letter. "It's extremely comforting and reassuring to be kept warm. Such a small gesture goes a long way," says Yanara Reda, RN, BSN, OR team leader at the Rockland and Bergen Surgery Center in Montvale, N.J. And yet despite the many proven benefits, the practice of warming is highly variable, dependent on such factors as the length and type of procedure, the mode of anesthesia, the patient's age and even the warming device(s) you use, according to last month's Outpatient Surgery Magazine online survey of 100 surgical facility leaders. Some key findings of our survey:

1. How often do you warm? More than half (53.0%) of our survey respondents warm every patient wheeled into their ORs and nearly one-third (30.0%) warm patients "sometimes." Quite often, the determining factor in whether our respondents actively warm patients is the duration of the procedure: 45 minutes for some, 60 minutes for others and, for a smaller subset, a case has to run at least 2 hours before they'll warm. "Any surgeries longer than 59 minutes," says Mechelle Kemp, BSN, manager of perioperative services at Elkhart (Ind.) General Hospital. "If they are having general anesthetic or the procedure is expected to last over 30 minutes," says Karen Rustermier, RN, BSN, CNOR, of the Nebraska Medical Center in Omaha, Neb.

One of the facility managers who reserves warming for longer procedures explains her rationale: "Most of our surgeries are under 30 minutes in length. We do warm the cases we know are going to last longer, such as shoulders, knees and any laparoscopy." Ms. Reda says time should be of no concern. "When you're naked under a thin layer of cotton, you feel vulnerable," she says. "Vulnerability doesn't have a time frame."

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