and conductive heating mattresses and showed that infection rates
decreased when FAW was not used. But Dr. Austin says the study fails
to mention what proportion of patients in each group had risk factors
— including physical status, incontinence and antibiotic regimens —
that made them more susceptible to SSIs. "Those factors are typically
noted in Table 1 of studies," points out Dr. Austin.
3. Body temperature drops quickly
Core body temperature drops significantly in the first 20 to 30 minutes
of anesthesia time and rebounds in actively warmed patients, so it
might be more challenging to maintain normothermia during shorter
surgeries. "Surgical teams understand that hypothermia is an issue,
but they don't appreciate how fast core temperatures drop in that
short period of time," says Dr. Austin. "Even when active rewarming is
used, you don't have the time to reestablish normothermia."
Nearly two-thirds of surgical patients become hypothermic during
the first hour of anesthesia, says Daniel Sessler, MD, the Michael
Cudahy Professor and Chair of the Department of Outcomes
Research at the Cleveland (Ohio) Clinic. Although one study reported
that 10 minutes of pre-warming is sufficient, Dr. Sessler says to stick
with 30 minutes of active warming in pre-op. The likelihood that
patients will become hypothermic during the initial phase of surgery
points to the importance of pre-op warming and instituting intraopera-
tive warming as soon as possible, says Dr. Austin. "If the patient starts
off surgery with a higher body heat content, it might not drop as low
during induction," he explains.
4. Raising the OR thermostat
You should keep the ambient temperature in the OR between 68°F
and 75°F, according to AORN recommendations. Dr. Sessler recently
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