water mattresses.
Introducing warmed irrigation fluids to help re-warm internal organs
when the peritoneal cavity begins to cool during surgery is another
option, notes Dr. Bashaw. She says this method is particularly useful
for longer surgeries (those lasting more than 60 minutes) because the
warmed fluids are continually infused throughout the procedure to
help maintain the patient's core temperature.
Attaching a device to the anesthesia machine that heats and humidi-
fies the anesthetic gases patients breath in can help maintain nor-
mothermia when used in combination with other warming methods.
"There are about 480 million alveoli in the lungs," says Dr. Bashaw.
"Imagine the warming effect that occurs when each of those alveolar
sacs fill with warm humidified air."
When deciding which warming method is best for a patient, assess the
factors that contribute to hypothermia: the patient's age, health condition
and comorbidities, and the case length and type of procedure.
Be sure to follow the manufacturer's instructions for whichever
warming method you choose, suggests Dr. Bashaw. She points out
that proper venting is key when applying forced-air warming to a
draped patient. The hose that connects warming gowns to forced-air
warming units can cause thermal burns to a patient's skin and could
create an oxygen-rich environment and potential fire hazard if heat is
not allowed to escape from under the drapes, according to Dr.
Bashaw.
If the findings of Dr. Giuliano's survey are any indication, don't
assume your nurses are up to speed on the best ways to warm
patients. The survey's findings reinforce the importance of informing
your team about clinical practice guidelines related to proper patient
warming, no matter how basic the recommendations might seem.
OSM
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