Outpatient Surgery Magazine

Manager's Guide to Staff & Patient Safety - October 2015

Outpatient Surgery Magazine, providing current information on Surgical Services, Surgical Facility Administration, Outpatient Surgery News and Trends, OR Excellence and more.

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O C T O B E R 2 0 1 5 O U T P A T I E N TS U R G E R Y. N E T 4 5 Never place IV fluids in a cabinet designed to warm irrigation solutions or cotton blankets, as the high temperatures could seriously burn and injure the patient. Instead, follow manufacturers' directions for use and have staff check the temperature of the fluid warmers periodically to ensure they are correct. provider has reported a single confirmed incidence of infection believed to be caused by the Bair Hugger device." Many of the allegations linking surgical site infections to forced-air warming were started by a surprising source — the inventor of the Bair Hugger, anesthesiologist Scott Augustine, MD, who after a contentious split from the company that sold the Bair Hugger to 3M, invented the HotDog patient warming system, an air- free device that works similarly to an electric blanket, warming the patient from above and below simultane- ously. Dr. Augustine claims in an article in the The New York Times that the company selling the Bair Hugger knew of the infection risk as far back as 2010 and was covering up this danger to keep sales strong. "We didn't recognize the problem when I was running the company and remarkably over 20 years no one else did either," says Dr. Augustine. "About 6 years after I left the company, we accidentally discovered the unintended consequence of [forced-air warming]; the waste hot air vents near the floor, heats the con- taminated air resident near the floor, and then rises alongside the table into the sterile surgical field. We became very concerned about patient safety in ultra-clean surgeries such as total joint replacements. A sin- gle airborne germ landing on an implant can cause a devastating infection by protecting itself with biofilm." 3M vehemently denies the allegation, and several independent researchers, including the Association of PeriOperative Registered Nurses (AORN), say that studies showing evidence of a link are limited or use flawed methodologies. In a 2013 review (osmag.net/8nYxEY), AORN says that "given the efficacy of these devices in preventing inadvertent perioperative hypothermia" facilities can continue using forced-air warming "until well-conducted, large-scale trials can further examine the issue." — Kendal Gapinski

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