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P A T I E N T
W A R M I N G
IV fluids and ensures the temperature
effects of hypothermia on all aspects
is set at 70°F or greater during the first
of surgery and recovery. "Since then,
few minutes in the OR. When a patient
research has shown that keeping
is rolled into the OR, Ms. Burns checks
patients normothermic decreases
that he is covered with a
forced-air warming blan-
appropriate puts booties
"Warming should be treated like any other
medical intervention, like medications.
It should be the right amount for the right
patient at the right time."
on his feet, again to con-
— Daniel I. Sessler, MD
ket, wraps his head to
conserve heat and if
serve heat. She'll also
blood loss and reduces length of stay.
use humidified anesthesia gases to fur-
"Warming should be treated like any
ther warm patients.
other medical intervention, like med-
"No one single action is the best for
keeping a patient warm," says Ms.
ications," he adds. "It should be the
Burns. "American Society of
right amount for the right patient at
PeriAnesthesia Nurses' guidelines rec-
the right time. Most patients should be
ommend all of these actions."
kept normothermic."
Some recent studies question the
effectiveness of banking patients' heat
The critical first hour
by pre-warming them before they
Anesthesia is the main cause of
reach the OR, but the preponderance
hypothermia, with the elderly and the
of research over the past 40 years sup-
very young at biggest risk. "Just after
ports warming for myriad reasons.
induction of anesthesia, heat leaves
"Our research in the mid '90s
the trunk and head, and goes to the
showed that normothermia reduced
the risk of surgical wound infection,"
core body temperature," says Dr.
says Dr. Sessler (NEJM.
Sessler. "Redistribution is the main
1996;334(19):1209-1215), who has con-
cause of hypothermia during the first
ducted hundreds of studies on the
8
arms and legs, which reduces the
hour with both general and neuroaxi-
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O U T PAT I E N T S U R G E R Y M A G A Z I N E | J U LY 2013
