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 3
tices in safely maintaining normothermia. Let's look at some of the most com-
mon ways to warm patients, and the mistakes to avoid when using each one.
1. Forced-air warming
If you're careless, forced-air warming can do more harm than good. "Free
hosing" is an especially dangerous practice. Inserting the unit's hose under
drapes or a blanket can cause serious burns to the patient. Always use the
blankets designed for forced-air warming when using these systems.
Additionally, if you're using forced air intraoperatively, be careful to avoid
placing the forced-air warming blanket on a limb that's not being perfused. For
example, if you have a tourniquet on a patient's arm and use forced-air warming
on that arm, you're heating up the tissue and not letting that heat distribute
throughout the body. This, in turn, can cause a burn.
While these injuries are rare, a more common mistake is not using the
blankets before anesthesia induction. For forced-air warming to be effective,
evidence shows that you must apply the blanket 30 minutes before surgery,
in addition to using it intraoperatively. If you start using forced-air warming
only after anesthesia induction, the patient may already be hypothermic.
2. Warmed blankets and fluids
Do you wrap warm cotton blankets around patients to try to maintain nor-
mothermia? Evidence has shown that this technique is not overly effective.
While a patient may enjoy the comfort a warm cotton blanket provides, the
blanket cools quickly and doesn't keep the patient's skin or muscles warm.
Use warmed cotton blankets to enhance the comfort of patients, not as a
primary method of patient warming.
If you store cotton blankets in a warming cabinet, keep in mind that it must
be set to the correct temperature, which can be found in the manufacturer's
instructions for use. Staff should check cabinets periodically to ensure that the
set temperature is correct and that the cabinet is working properly.
