M A Y 2 0 1 7 O U T P A T I E N TS U R G E R Y. N E T 2 3
are placed over or under patients to effectively maintain normothermia. Care
must be taken to prevent burns if a conductive fiber warming mattress is used.
These fabrics aren't disposable, so they must be disinfected between uses,
which can become a compliance issue in a busy facility.
•
Warmed blankets
sit at the top of patient satisfiers. However, these common
comfort measures are essentially ineffective in preventing hypothermia, at least
when they're used alone on at-risk patients during extended procedures. Warmed
blankets can help decrease cold air currents moving across the patient's skin, but
cannot compare to active warming methods in effectively maintaining normother-
mia.
Given the risks, benefits and costs of each option, conductive fiber warming
and forced-air warming are probably the most efficacious choices for limiting
risk of post-op infection.
3. Who's most susceptible to hypothermia?
The very young and very old are at increased risk. It's essential to apply active
warming methods to the frail, elderly and emaciated patients who have lost insu-
lating tissue mass. Sickle cell patients are also sensitive to cold and could experi-
ence a sickle cell crisis if they become hypothermic. Surgeries that expose large
areas of the patient's skin to the cold operating room environment or to cold irri-
gating fluids, as well as procedures lasting longer than 1 hour, demand the use of
active warming methods. The ambient temperature in the operating room should
be kept between 68°F and 75°F, according to AORN, but that recommended
range is rarely followed by surgical teams who consider their own comfort
before the infection risks of patients. Consider actively warming patients during
even short procedures if your staff refuses to turn up the heat in the OR.
4. Is pre-op warming necessary?
Most evidence does show that pre-op warming is effective and should be con-
sidered for many patients. Patient temperature falls very rapidly during the first
