Here's a rundown of several patient warming methods you can use
to maintain normothermia based on insights from Paul Austin, PhD,
CRNA, a professor of nurse anesthesia at Texas Wesleyan University
in Fort Worth.
• Cotton blankets. Patients love being wrapped in warmed blankets,
but applying the common comfort measure alone won't prevent
hypothermia. Blankets are best used to augment active heating meas-
ures and boost patient satisfaction scores.
• Convective warming. Disposable and lightweight warming gowns
help maintain the body's core temperature, but could impede access to
the surgical site, meaning full body covers might have to be replaced
with smaller coverlets in the OR. The debate about a popular forced-
air warming unit's link to surgical site infections is currently playing
out in the federal courts (see "Bair Hugger Absolved in Forced-Air
Bellwether Trial" on p. 38).
• Conductive fiber warming. This solution directs heat through
blankets and mattresses placed over and under the patient to warm
from below and above at the same time. The fabrics on these devices
must be covered with a disposable cover or disinfected between uses.
• Warmed irrigation and IV fluids help maintain normothermia, par-
ticularly if the case includes administering large amounts of cold fluid
quickly. An important note: Closely follow the directions provided by
the manufacturers of fluid warming units that pertain to how long you
can safely warm fluid and the maximum allowed temperature to which
the fluid can be warmed. AORN suggests you warm IV and irrigation
solutions in their own warming units or in units with separate blanket
and fluid warming compartments that have independent temperature
controls.
• Thermal reflective blankets, which reflect the patient's radiant
body heat to maintain body temperature, have some proven efficacy
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