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minutes or longer under general or neuraxial anesthesia, according to the
Surgical Care Improvement Project and the Physician Quality Reporting
Initiative. According to the guidelines, you should record a body temperature
equal to or greater than 36°C within the 30 minutes immediately before or the
15 minutes immediately after anesthesia end time. Keep in mind that hypothermia can still occur in patients during cases lasting less than 60 minutes. While
these patients aren't considered high risk, they can and will feel cold, so warming as a comfort measure is still recommended during shorter procedures.
2. When do you warm patients? Then there's the question of when
to warm: in pre-op, during the case or in recovery. At the Chickasaw Nation
Medical Center in Ada, Okla., patients choose whether they'd like to be prewarmed. "We connect patients to a forced-air warming gown and let them decide
to use it or not pre-operatively," says Surgery Center Manager Ralania Tignor,
BSN, RN, CNOR. "Intraoperatively, anesthesia decides." Here's how our survey
broke down — 32.7% warm pre-operatively, 56.1% warm intraoperatively, 37.8%
warm post-operatively and 39.8% warm throughout the patient's stay.
"I would prefer pre-op warming, but it is not yet available at the facility that I
work in," says Dennis Thompson, MD, clinical professor of plastic surgery at
Olive View-UCLA Hospital in Sylmar, Calif.
The University Medical Center in Las Vegas, Nev., is initiating a patient warming initiative that includes patient-controlled pre- and post-op forced air warming, says Ren Scott, MSN/Ed, RN, CNOR, clinical educator of surgical services.
"Patient warming throughout the perioperative experience will improve patient
outcomes and increase patient satisfaction/comfort," he says.
3. What's your rationale for warming? This was close. At 85.9%,
"make patients comfortable" edged out "prevent hypothermia and its clinical
complications," which 82.8% of respondents chose. Other reasons prominently
mentioned include "reduce recovery times," "ward off surgical site infections"
