Archive December 2018 XIX, No. 12

Thinking of Buying... Patient Warming Devices

Exploring the many ways to prevent hypothermia.

Paul Austin

Paul Austin, CRNA, PhD


Convective or conductive? Below, above or around the patient? Before, during or after the procedure? Blankets or blowers? Covers or pads? Yes, there's no shortage of ways to maintain normothermia, but no matter the warming device you choose and use, they all share the same goal: to prevent hypothermia.

As you'll see in the thumbnail sketches of 12 warming products over the next few pages, today's devices warm the patient in very different ways. Some even do double duty, like the forced-air warmer that's also an OR table positioning drape and the pressure-reducing OR pad that also warms the patient.

Then there's our more traditional warming methods: blanket and fluid warming cabinets, forced-air warmers (air to surface) and conductive-fiber warming blankets (surface to surface). Employing them separately or in combination can optimize your efforts to maintain normothermia.

Among other things, keeping patients warm helps limit the risk of post-op infections, decreases bleeding and can lead to faster recoveries.

If we don't actively warm our patients, we worry about unintended hypothermia and complications like increased blood loss or cardiac events. That's why pre-warming in the holding area before going into the OR is important. The colder the periphery — the arms and legs — are to start, the more redistribution of heat from the core to the periphery will occur, resulting in a colder patient.

When patients undergo general anesthesia or major neuraxial anesthesia like a spinal or epidural, they experience arterial vessel dilation in the arms and legs, leading to a redistribution of heat from the thorax and abdomen to the body's periphery. Redistribution can lead to a rapid decrease in the patient's temperature — up to 2°C per hour. If you don't do anything to keep the patient warm, their temperature will quickly go from about 37°C to around 35°C during the first hour of surgery.

You also have a financial incentive to warm patients. Medicare's Merit-Based Incentive Payment System calls for measuring perioperative temperature management for patients who are under anesthesia for more than an hour. It requires you to use a method of active warming and also for at least one body temperature reading to be equal to or greater than 35.5°C or 95.9°F within 30 minutes before or 15 minutes after anesthesia end time. OSM



Bair Hugger Underbody Blankets

Price: Not disclosed

FYI: Bair Hugger Underbody Blankets warm the patient while providing full, unrestricted patient access. You can position the blankets on the procedure table before the patient arrives. An outer channel surrounds the patient, directing warmth to both the core and periphery. Comes in 25 different styles, for routine to complex cases.


Augustine Surgical

HotDog Patient Warming System

Price: $279/month per OR for underbody and overbody with monthly warming plan

FYI: This system warms patients safely and effectively with conductive-fabric warming blankets and underbody mattresses. It's the only system that warms above and below the patient simultaneously. Compact controllers and advanced sensors deliver low-voltage electricity to the flexible, lightweight devices for uniform and precise heat.

Opt-Shield Air

BCG Medical

Opt-Shield Air

Price: Not disclosed

FYI: Opt-Shield is a do-it-all OR table positioning drape that secures, protects and warms patients with forced air. Designed for lithotomy/Trendelenburg position procedures, the ingenious drape connects to a forced-air warmer once you've positioned and secured the patient in steep Trendelenburg. Passive warming and insulation to the arms and legs minimize heat loss during surgery, says the company. Low-friction fabric aids in lateral transfer.

Blanket and Solution Warming Cabinet


Blanket and Solution Warming Cabinet

Price: Not disclosed

FYI: This double-door cabinet warms blankets and solutions in 2 separately heated compartments. The temperature control is set via key and pass-code lockout and ensures that the temperature remains within plus or minus 1°F of the set point. It has self-closing, magnetic gasket, adjustable-tension doors and there is a no-set temperature restriction between compartments. Each cabinet unit comes standard with integrated casters for ease of mobility.

WarmAir Convective Warming System


WarmAir Convective Warming System

Price: Not disclosed

FYI: With this warming system and the company's FilteredFlo blankets, all air is filtered twice before being distributed to the air blanket. The patented design of the blankets permits use of a lower velocity blower to supply the air, and the filtered air warming method helps minimize air currents in the operating room environment. The warming unit offers quiet operation and 4 levels of therapy.

It's compact, with a light frame and has high and low temperature alarms.

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