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Warming the patients' skin and peripheral tissues before induction
or anesthesia prevents so-called redistribution hypothermia. If prewarming occurs before the redistribution phase, you can reduce or
eliminate hypothermia. Effective pre-warming "banks" the patient's
heat so the patient arrives at the OR normothermic. If you forgo prewarming, patients might arrive in the OR normothermic, but they'll
arrive in PACU hypothermic.
"Our ideal is to pre-warm, and we do if they are a.m. admits," says a
reader. "The non-scheduled cases don't always get pre-warmed."
Another lamented the fact that she doesn't have enough warming
devices to pre-warm all patients.
For another hospital in our survey, the policy is to pre-warm patients
with a forced-air warmer if the anesthesia will last longer than 15 minutes. In a randomized study by Katie Hooven (2008), more than twothirds (68%) of patients who were pre-warmed with a portable warming
device remained normothermic during and after surgery. In comparison,
only slightly more than two-fifths (43%) of the patients who weren't prewarmed remained normothermic.
"Because the skin of the patient is warm, the need for the body to
redistribute heat from the core to the periphery is reduced and normothermia is better maintained," says Deborah Edgeworth, BSN,
CNOR, interim manager of surgical services of Genesis Medical
Center in Davenport, Iowa.
For shorter cases — some estimate that 59% of outpatient proceA P R I L 2 013 | O U T PAT I E N T S U R G E R Y M A G A Z I N E | 5 7
