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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
not longer, due to adhesions), the patient will be particularly susceptible. The exposed and open abdomen makes warming from underneath a more suitable choice.
Patient 4: A 40-year-old man with a history of exercise-induced
asthma, but otherwise healthy, with a BMI of 21.7. He will undergo a
full-thickness rotator cuff repair, sustained playing recreational sports.
His pre-op temperature is 36.7°C.
• Warming methods: Provide a warmed blanket for pre-op, and cap
and socks for the duration. Use warmed irrigation fluids and a warm
blanket and forced air in the OR and in PACU.
• Reasoning: Although the patient is a low-risk candidate for outpatient surgery, he is on the thin side — and lower-bodyweight patients
are at risk due to having less natural insulating ability and having large
body surface area to body mass ratios. Because of such factors, these
patients experience a high amount of body heat loss, especially during
the initial redistribution phase. Further, the use of general anesthesia
(plus a nerve block) and the longer procedure time mean taking extra
precautions. In addition, the larger fluid loss that comes with
arthroscopy puts the patient at higher risk of perioperative hypothermia, and the beach chair position makes unobtrusive warming difficult. Warmed fluids are therefore key to maintaining normothermia.
Patient 5: A healthy 18-month-old girl with a history of ear infecN O V E M B E R 2012 | O U T PAT I E N T S U R G E R Y M A G A Z I N E O N L I N E
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