not the OR, so we take that opportunity to get them warm blankets immediately
prior to transport," says Mr. Long. "Immediately hooking them back up to the
warmer in PACU is also a priority. I notice patients will sometimes complain of
more post-operative pain if they are also cold. Appropriate pain control, absence
of nausea and a comfortable post-operative temperature adds up to a very satis-
fied patient."
The 'Se vo Shake'
Mr. Long warns of an "almost unbearable" combination for patients: a cold OR
coupled with sevoflurane or desflurane, 2 inhalational agents that have been
linked to post-op shivering. "During my anesthesia training, we learned it as the
'Sevo Shake,' especially when we would use LMAs and pull them deep." When
the patient is spontaneously breathing with an adequate airway but has higher
residual levels of the agent in his system, he continues to breathe it off in PACU
while waking up, says Mr. Long. "Combine this high residual agent with a low
core body temperature, and you'll sometimes see the 'Sevo Shake,'" he says.
Sterile instruments and skilled surgeons matter, but so do the most basic
needs. "Patients just want to be warm and comfortable," says Fawn Esser Lipp,
RN, BSN, CNOR, the chief clinical officer at The Surgery Center in Franklin,
Wis.
OSM
4 4 S U P P L E M E N T T O O U T PAT I E N T S U R G E R Y M A G A Z I N E January 2015
E-mail doconnor@outpatientsurgery.net.
