4 2 S U P P L E M E N T T O O U T P A T I E N T S U R G E R Y M A G A Z I N E M A Y 2 0 1 6
hypothermia.
Routinely warming every patient
The key to maintaining normothermia lies in actively warming patients with
blankets, blowers, underbody mattresses or IV fluids, what Terry Wicks,
CRNA, MHS, a staff anesthetist at Catawba Valley Medical Center in Hickory,
N.C., refers to as "cost-effective and efficient solutions that assist anesthesia
clinicians in preserving surgical patient thermal homeostasis."
But not every surgical facility routinely warms every patient. The question of
whether to warm is usually the anesthesia provider's to answer based on such
factors as the duration of the case and the type of anesthetic. He might, for
example, actively warm patients undergoing general anesthesia, which can
enhance hypothermia as it causes a tonic vasoconstriction of the peripheral
blood vessels. He'll reserve active re-warming for regional anesthesia patients
only if intraoperative hypothermia is documented or if the case is expected to
last more than 60 minutes.
"If we can prevent some surgical site infections
by warming patients, then we must strictly main-
tain normothermia during surgery," says Theresa
Criscitelli, EdD, RN, CNOR, the assistant director
of professional nursing practice and education at
Winthrop-University Hospital in Mineola, N.Y.
Do forced-air warming
blankets increase SSIs?
Further complicating matters are the allegations that
forced-air warming blankets can increase the infec-
tion risk in patients undergoing total joint replace-
ment surgery. The allegations state that forced-air
warmers stir up bacteria from the OR floor and dis-
• SSI LINK Craig Silverton, DO, and his team
of researchers at The Henry Ford Hospital,
found that hypothermia is associated with an
increased risk for infection in patients who
undergo surgery to repair a hip fracture.
