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agreed to keep the room temperatures set as they were.
Start active warming practices in pre-op for patients who have recorded tem-
peratures less than 36°C and for those who might be at increased risk of
hypothermia: women, the very old and the very young, and individuals with sys-
tolic blood pressure less than 140 mmHg. But why not apply active warming
measures to all patients — aside, perhaps, from those who undergo minor pro-
cedures lasting less than 30 minutes or those who receive local anesthesia — to
be sure they remain normothermic until discharge?
Active warming, which involves forced-air warming or conductive fiber warm-
ing devices, can be applied in pre-op to lessen the chill of hypothermia. Warmed
cotton blankets are a definite patient perk and appreciated comfort measure,
but their use alone has not been proven to reduce the risk of hypothermia. Still,
applying blankets is a good way to augment active heating measures and boost
your patient satisfaction scores.
Warming IV fluids is another effective way to maintain normothermia, especial-
ly during cases that require the infusion of a large amount of fluid in a short
amount of time. Follow the manufacturer's directives for how long you can store
the bags in fluid warming cabinets and the maximum allowed temperature to
which you can warm them. AORN suggests you warm IV and irrigation solutions
in separate warming cabinets or in warming units with separate areas with inde-
pendent temperature controls.
Active warming methods, warm cotton blankets and warmed IV fluids are
most effective when used in combination than when they're applied alone.
Regardless of the warming methods you use, the goal is the same: to make sure
patients are normothermic when they enter the OR.
Maintaining the momentum
The impact of your pre-warming efforts will quickly fade if you lose focus on keep-
ing patients normothermic during surgery. A cold body naturally shivers to warm
up, but unconscious patients in the OR cannot perform that most basic self-regulat-
