determine if we can realize significant savings. Anesthesia providers
in the hospital administer warmed IV fluids and apply forced-air
warming to every patient who undergoes surgery, regardless of proce-
dure type or length. When you consider the main ORs host 50 to 100
patients a day, eliminating the $35 to $100 that active warming adds to
the cost of a case could produce significant savings over the course of
a year.
However, CMS's Surgical Care Improvement Project recommends
active warming for patients who undergo procedures lasting longer
than an hour. Medicare won't fully reimburse hospitals for the care of
a patient if a hypothermic event occurs during surgery or if a surgical
site infection can be linked to hypothermia, so there are significant
financial implications associated with failing to maintain normother-
mia that drive the policy of applying forced-air warming to all patients
in our main ORs. ASCs don't yet have Medicare reimbursements tied
to meeting SCIP guidelines, but it's moving in that direction, and at
some point they will be held to the same patient warming standards.
A neurosurgeon has offered to help me conduct the surgery center
study in the medical center's main ORs with the hope of publishing
the results in a peer-reviewed journal. If a clinical trial can definitely
prove that warmed blankets are as effective as active warming in pre-
venting hypothermia, CMS might have to reconsider its SCIP stan-
dards. Will that ever happen? Maybe. But until it does, active warming
remains a key component of hypothermia prevention efforts.
Combining it with warmed IV fluid and warmed cotton blankets helps
keep patients normothermic.
Take care of our own
You want to prevent hypothermia because when the core body tem-
peratures dips below 36°C, a cascade of adverse events can occur,
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