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P R E V E N T I N G
H Y P O T H E R M I A
sion, to be used from pre-op through to post-op. Provide a thermal
bouffant hat and socks, also to be worn throughout. Consider using
forced-air warming in PACU, depending on the patient's body temperature after the procedure.
• Reasons: Cataract procedures are one of outpatient surgery's mainstays for good reason: They are safe and low-risk. The OR time is less
than 15 minutes, and patients can leave street clothes on during the
procedure, both of which help minimize loss of body heat. In addition,
anesthesia isn't "heavy;" all that's needed is topical anesthesia with a
little IV sedation to alleviate his anxiety. These factors remove much
of the risk of perioperative hypothermia in patients.
However, elderly patients, particularly those who have pre-existing
cardiovascular conditions, must be approached with caution. Elderly
patients have reduced muscle mass and less body fat, reducing the
body's natural insulating ability. This patient group also has reduced
thermoregulatory abilities. As such, patients older than 55 years are
considered to be at increased risk of hypothermia. In addition, even
moderate pre-op anxiety can affect body temperature. Active prevention efforts are best with this patient, despite the low procedural risk.
Patient 3: A 45-year-old male manual laborer who is overweight
(BMI of 27) and has a history of sleep apnea. He will undergo open
hernia repair, due to adhesions from a previous repair. His body temperature before the 8 a.m. procedure is 36°C.
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