in preventing hypothermia, but are not as effective as active warming
methods and cannot be used during all surgical procedures.
• Warm circulating water mattresses can be effective in maintain-
ing normothermia, but, depending on the patient's weight and the heat
of the mattress, can increase the risk of pressure sores. These devices
have largely fallen out of favor due to safety concerns and a lack of
efficacy compared with other active warming methods.
• Electric heating blankets effectively warm patients, but come
with concerns of electrical hazards as a result of insufficient insula-
tion, outer sheath breakage or inadvertent cutting of the outer surface
by surgical instruments. Patients can suffer burns due to inefficient
and uneven heat transfer to the surface area of the blankets.
• OR temperature. The ambient temperature in the operating room
should be kept between 68°F and 75°F, according to AORN. That can
be an issue in many facilities where surgical team members lower the
temperature as they work hard while gowned up under warm lights.
Early and often
Pre-warming patients in pre-op prevents hypothermia from setting in
when anesthesia is administered. It also eliminates playing catch-up to
reestablish normothermia in the OR.
Employing various warming techniques in combination optimizes
your efforts to maintain normothermia, according to Dina Velocci,
DNP, CRNA, owner of Velocci Anesthesia Services in Nashville, Tenn.
"The biggest thing is to not rely on only one method to warm
patients," she says.
Maintaining normothermia shouldn't hamper the surgeon's access to
the surgical site, points out Dr. Velocci. When deciding which warm-
ing method to use, consider the type of case, the position the patient
will be in, and the incision size and location. During abdominal cases,
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