J U LY 2 0 1 5 O U T P A T I E N TS U R G E R Y. N E T 3 3
not augment
your arsenal?
Pre-warming
and using 2
different
warming sys-
tems are the
best ways to
do that, sug-
gests Dr.
Sessler. "You
can also keep
anybody warm by increasing ambient OR temperature sufficiently," he adds.
"But you have to increase it much more than you'd think, and then you'd make
everybody in the room miserable. It works, but it's not a very sophisticated solu-
tion."
By combining 2 effective warming systems, you'll have more impact than you
would with either alone. "Each warming method involves a tradeoff of cost,
ease of use and risk," says Dr. Sessler. "You need to decide what's best in their
particular context."
Once the pre-warmed patient is inside the OR, for example, fluid warming can
help reduce the cooling effect caused by room-temperature fluids. However, it's
only effective in patients who receive large volumes of fluid.
"Often, fluid is given as a larger bolus at the beginning of the case," says
Charles E. Smith, MD, director of cardiothoracic and trauma anesthesia at
MetroHealth Medical Center in Cleveland, Ohio. "You may give 300 ml or 500 ml
to a typical adult. If you keep those fluids warm, you've helped with heat conser-
vation." He says giving patients fluid that matches their body temperature is part
of thermal homeostasis: You're maintaining normal blood volume distribution
Pamela
Bevelhymer,
RN,
BSN
z YOU'RE GETTING WARMER Pre-warming patients
can help reduce bleeding and other adverse events.
